Hutchinson hospital settles with feds in false Medicare claims case

Posted by:  :  Category: Medicare

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Source: kansas.com

Video: Medicare Supplement Plans Kansas City | 816-482-9711

2 Large Kansas Hospitals to Refund Medicare Overpayments

Both hospitals only partially agreed with the OIG’s audit. University of Kansas Hospital officials said they will repay $175,653 of their recommended total, but they contested the findings on 15 inpatient claims, saying the OIG did not consider the “extenuating circumstances” those patients had. Via Christi officials said they would refund about half of the OIG’s recommended total, but the remaining billed claims were justified as inpatient.
Source: beckershospitalreview.com

Kansas Health Care Professionals: Protect Your License, and Beware of Medicare & Medicaid Fraud

Open the newspaper or turn on the television and you are sure to see a story about the widespread prevalence of Medicare and Medicaid fraud by health care professionals. As a result, the United States Department of Justice has made it a top priority to track down those health care professionals who have engaged in such fraudulent practices. In July, a Miami psychiatrist and six other therapists were arrested on charges that they schemed and defrauded over $60 million dollars from the Medicare program. Medicare and Medicaid fraud is not only a federal crime, it can also cost a health care professional his or her professional license. One way to protect yourself and your license is to be vigilant. The following are some of the most common Medicare/Medicaid fraud schemes plaguing health care professionals:
Source: sangerlawoffice.com

Obamacare could encourage more early retirements from baby boomers

FILE -In this March 23, 2010, file photo President Barack Obama is applauded after signing the Affordable Care Act into law in the East Room of the White House in Washington. If the law survives Supreme Court scrutiny, it will be nearly a decade before all its major pieces are in place, and even if he is re-elected, Obama won’t be in office to oversee completion of his biggest domestic policy accomplishment, assuming Republicans don’t succeed in repealing it. The law’s carefully orchestrated phase-in is evidence of what’s at stake in the Supreme Court deliberations that start March 26, 2012. (AP Photo/Charles Dharapak, File)
Source: kansascity.com

Kansas Public Radio Report on Medicare Part B DTS

Please click on the following link to hear a report from Kansas Public Radio related to the July 1, 2013 changes in how diabetic testing strips are provided to Medicare Part B patients.  The report includes comments from Kansas Independent Pharmacy Service Corporation (KPSC) CEO, Pete Stern, expressing concern about how these changes negatively impact independent pharmacies as well as their patients.  The report also includes comments from KPSC stockholders Jeff Denton and Don Atwell of B & K Prescription Shop in Salina.
Source: kspharmserv.com

Medicare Wellness Visits: They’re FREE…But What Are They?…By Lynne Kallenbach, M.D.

This is an excellent occasion to review recommended preventive testing, update your medication profile, and talk to your doctor about how to stay healthy. It also affords the chance to detect other concerns which might not otherwise be apparent and would warrant additional investigation. It can also provide a blueprint for the services and health issues that may need addressed over the next several years.
Source: kcim.com

Kansas Medicare Recipients To Get New Summaries

Storms will impact parts of KAKEland this afternoon and into the evening hours, with the primary threats being gusty winds and some hail. Keep it with the KAKE First Alert Forecasters for the latest weather information as the situation develops.
Source: kake.com

Kansas Congressional Delegation Responds to Report on Critical Access Hospitals

“Moreover, eliminating CAHs per the OIG’s proposal would trigger a devastating chain reaction, causing not just one CAH to lose its designation but other CAHs that would fall under the report’s modified distance requirement. The absurd result of such a scheme would most likely lead to the closure of both hospitals, severely rationing care in rural America. Also under this proposal, if a CAH lost its designation and became a subsection D hospital, the status of other facilities with alternative Medicare designations, such as Medicare Dependant or Sole Community Hospital status, would be altered as well. This would result in multiple hospitals suddenly facing substantial Medicare cuts and severe financial challenges. In a single blow, the OIG report’s proposals would jeopardize the survival of the majority of CAHs in Kansas and access for their patients who depend on these and other rural health facilities for care. These hospitals already operate on small margins because they provide care to increasingly aging populations across wide areas with a low reimbursement structure. Additionally, these CAHs are extremely important to their respective local economies as one of their largest employers.
Source: hutchpost.com

July 30, 1965: Johnson signs Medicare into law

The Medicare program, providing hospital and medical insurance for Americans age 65 or older, was signed into law as an amendment to the Social Security Act of 1935. Some 19 million people enrolled in Medicare when it went into effect in 1966. In 1972, eligibility for the program was extended to Americans under 65 with certain disabilities and people of all ages with permanent kidney disease requiring dialysis or transplant. In December 2003, President George W. Bush signed into law the Medicare Modernization Act (MMA), which added outpatient prescription drug benefits to Medicare.
Source: todayinkansas.com

Medicare Advantage: The canary in the coal mine

Posted by:  :  Category: Medicare

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The goal is obvious: destroy the incentive for patients to enroll in Medicare Advantage and push patients back to traditional Medicare. This effect is antagonistic to the stated objectives and selling points Democrats use to vehemently defend the controversial law. While progressives stump for the law and brag about its so-called market-based approach, their prized legislation quietly eliminates healthcare freedom for the more than 14 million current Medicare Advantage enrollees, gradually using market forces to push them all into the Medicare fee-for-service system. In effect, the phase-out from Medicare Advantage to fee-for-service is nothing more than a move from markets to a government monopoly.
Source: dailycaller.com

Video: Apply for Medicare | Medicare Sign Up

Do you know someone who needs help with prescription costs?

Anyone who has Medicare can get Medicare prescription drug coverage. People with limited income and resources are eligible for Extra Help to pay for the costs—monthly premiums, annual deductibles, and prescription co-payments—related to a Medicare prescription drug plan. You can help someone you care about apply for Extra Help with their Medicare prescription drug costs.  Many people with limited income and resources qualify for these big savings and don’t even know it. To find out if someone is eligible, Social Security will need to know their income and the value of their savings, investments and real estate, other than their home. Those married and living with their spouse, will need this information for both of them.
Source: srperspective.com

Funding Details: Arkansas Medicare Rural Hospital Flexibility Grant Program (CAH/FLEX)

Participating Critical Access Hospitals will receive a comprehensive audit of cost, revenue and departmental productivity performance, including an analysis of top recommendations that will result in greater financial and operational improvement based on internal and external benchmarks. Hospitals will analyze the information provided and select one or more improvement interventions.
Source: raconline.org

Sightings Over Sixty: I Apply for Medicare, Part I

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

Medicare Advantage And Medigap Applications Connecticut 2013

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

Federal Shutdown: What’s Closed And What’s Open?

WHAT CLOSES: * Any federal agency that’s subject to appropriations. Each agency has the discretion to decide who is “excepted” or “emergency”, and who is furloughed. * All National Parks * All federally-funded museums, including Smithsonian and the National Zoo. * All federal government websites * Research by Health and Human Services stops. So does the grant process. Depending on how long it lasts, that will also impact medical research at hospitals and universities. * Applying for Social Security. If you’re a new retiree, your application won’t be processed. * IRS walk-in centers. Your paper tax return will not be processed. * Loan applications for small businesses, college tuition, or mortgages. * All Library of Congress buildings. All public events will be cancelled and web sites will be inaccessible. * Federal contractors will be out of work. * Federal workers (except “excepted” or “emergency” personnel) will not be allowed to work, not even from home. No blackberry, no smartphone, no laptop. Not even allowed to check work email.
Source: cbslocal.com

HHS announces first guidance implementing Supreme Court’s decision on the Defense of Marriage Act: Application To Medicare, Nursing Homes, and Same Sex Married Couples Regardless of Where They Live

Under current law, Medicare beneficiaries enrolled in a Medicare Advantage plan are entitled to care in, among certain other skilled nursing facilities (SNFs), the SNF where their spouse resides (assuming that they have met the conditions for SNF coverage in the first place, and the SNF has agreed to the payment amounts and other terms that apply to a plan network SNF).  Seniors with Medicare Advantage previously may have faced the choice of receiving coverage in a nursing home away from their same-sex spouse, or dis-enrolling from the Medicare Advantage plan which would have meant paying more out-of-pocket for care in the same nursing home as their same-sex spouse.
Source: wordpress.com

Daily Kos: Damaged Medicare

Medicaid is a state program.  Here are the rules for New Jersey: The Division of Medical Assistance and Health Services (DMAHS) is reinforcing and updating guidelines that were issued in Medicaid Communication No. 00-16, dated August 10, 2000, governing the recovery of correctly paid Medicaid benefits from the estates of deceased Medicaid clients or former Medicaid clients. The following is a list of important points to remember when determining eligibility and discussing this topic with applicants, clients, authorized representatives and families: • Medicaid benefits received on or after age 55 are subject to estate recovery. This is specifically stated and acknowledged on the authorization page of the PA-1G Medicaid Application Form. • DMAHS has an immediate right to recover from the estate unless there is a surviving spouse or child(ren) who is under age 21 or who is blind or permanently and totally disabled. Should any of these exceptions to DMAHS’ right to recover from an estate no longer apply (e.g., death of surviving spouse, attainment of age 21 by surviving child, or death or termination of disability of blind or permanently and totally disabled child), DMAHS has a right to recover from any remaining estate assets at that time. • Estate recovery in New Jersey includes payments for ALL services, not merely services for institutionalized clients. There is no limitation on the type of service for which DMAHS can recover its payments from estates including managed care (HMO) capitation fees. However, effective January 1, 2010, Medicare cost-sharing benefits paid under the Medicare Savings Programs such as “Buy-in”, Specified Low-Income Medicare Beneficiaries (“SLMB”) or Qualified Individuals (“QI-1”) are not subject to estate recovery. • The estates of deceased clients who were enrolled in various Title XIX Waiver Programs (such as ACCAP, GLOBAL Options, CCW, etc.) ARE subject to recovery. … I hope this fills in the gaps on how this rolls.  Every state has similar “estate recovery” programs which are an important feature of “revenue neutral” O’care.
Source: dailykos.com

Cigna Medicare Plans And Blue Cross Medicare Plans An Overview

Posted by:  :  Category: Medicare

HMO (Health Maintenance Organization) skeleton are the smallest costly option. The outcome of descend cost is reflected as limited access to illness care. Plans have a set monthly fee, casing doctors inside of the plan. If you revisit a doctor outward of the plan, you are then accountable is to bill. Within a since plan, you have since the correct to select a Primary Care Physician (PCP) who will look after your care. The HMO CIGNA medicare skeleton cover periodic and surety caring costs, referrals to a network dilettante or trickery when necessary, treatment for injuries and illness. There is no need of profitable any extra fees in HMO skeleton as it has no fees for doctor visits. The CIGNA Part D outline is called CIGNA Medicare Rx offers coverage for 94% of existing drugs, access to over 58,000 network pharmacies, no deductibles for select plans, no copayments for familiar drug and diseases similar to diabetes and drug pressure. The CIGNA outline D in spin offers 3 variety of skeleton namely, Plan 1, Plan 2 and Plan 3.
Source: yuanshyang.com

Video: Medicare Advantage Plans from Cigna-HealthSpring [4 of 6]

merifontain: Cigna Medicare Plans And So Blue Cross Medicare Plans An Article

End up being however, advised how the person going to get a Talking Medigap Plan F for Dummies idea should study the sale documents of all of the Medigap plans you do a decision. All the 11 Medigap policies encapsulate the basic benefits, but each an individual has some additional beneficial properties along with them. In brief it can be told us that the Plan Some sort of is the easiest plan. However the Plans B-L provides all the great things about Plan A as well as , along with they provide some further more coverage. Any Plans K-L allows the benefits equivalent to Plans A-J, but the distinction is the cost-sharing for the basic benefits which varies at different stages. Treatment beneficiaries who are typical enrolled in a prescription drug and/or Medicare Advantage coverage and who contain questions about by what method changes from the Affordable Care (ACA) might affect them, should see contacting their state Senior Health Insurance plans Program (SHIP), a free of charge statewide health counseling service for Medicare beneficiaries in addition caregivers. Employing a web-based application, with regard to Kareo, is quite helpful in revitalizing billing productivity this is because it allows the source and billing want to stay connected. For one thing, the medical law firm has access to assist you patient accounts, could be helpful located in collecting outstanding looking after balances during an encounter. For your other hand, the biller has real-time access to regarding patient demographics, diagnoses, insurance, or any pertinent information necessary to prepare claims to make submission. Prior to going to shop for that Medicare Supplement insurance premiums one should know of the facilities that could be covered by an over-all Medicare plan. It is step 1 to understand exactly what supplement he/she personal needs after Medicare safety. The services one may buy from a Medicare are the health practitioner costs and extraordinary charges (part B), hospital costs (part A), at property recovery, emergencies all through foreign travel, price ranges of skilled nursing home, blood bank services, prescribed supplement costs and for that costs of preventive care. It’s wise to know and shop most desirable Medicare Supplement choose according to the drive. Associated with January 1, 2010, CMS increased all of the Medicare Part A deductible from ,068 so that it will ,100. Attribute A coinsurance figures increased from 7 to 5 each day for hospital branches from the 61st day in the hospital through the 90th day in the hospital. The coinsurance rate climb from 4 to make sure you 0 per working for the 60 lifetime reserve operating day. Also, coinsurance for Skilled Breastfeeding your baby Facility Care augmented from 3.50 every to 7.50 each and every day for days 21 through 100. Before beginning off with any other marketing plan you ought to sit down while visualize what kind of practice you wish to have? Do you want to focus on work-related care? Chiropractic care during pregnancy? Sports Injury? Will you have a blended focus? Envision your excellent practice as you would like it to are in five years. One Medicare Advantage plan of action may offer dentist profesionist and vision lots of benefits and some tasks offer more policies for doctor visits and hospital branches. It will be able to also cover many more diagnostic tests other than Medicare. A few plans offer a lot inpatient and outpatient services. Numerous Advantage Plans might even give your family a free declining health club membership. Your current recently signed Calm Protection and Most affordable Care Act for U.S. President Obama one more expected to change the retirement schematics of former People from the philippines and U.Ise. tax payers. Many anticipate that the “better” health service pledged by the fresh reform may not come out price.
Source: blogspot.com

Free Insurance Agent Websites: Cigna Medicare Advantage plans

CIGNA Medicare supplement plans have been an integral part of the insurance industry with having served customers for over 220 years. This kind of insurance plan can be very beneficial for all people including senior citizens who may be suffering from constant medical issues due to their advanced ages. The company enjoys a lot of goodwill among the community and here are some of the benefits that come with buying this plan.
Source: blogspot.com

Eligible Georgia Retirees Switching to Medicare Advantage Plans

What Does the Change Really Mean for My Doctors? It was detailed in July 15th letter that your doctor (provider) would need to accept the changes in the plan to accept the MA terms. From all the research and discussions that I have had with both doctors and insurance vendors, it does not seem like there will be many changes they believe (view the letter with all enclosures by clicking here). There are no networks. You may see any provider that accepts Medicare and is willing to accept CIGNA/UHC’s terms and conditions. The really important point to make is to have your provider agree to accept the new plan changes (information on the plan was given in the July 15 letter). Along those lines, I have received a few emails talking about the problems with finding Medicare Advantage doctors. Numerous articles have said that the vast majority of doctors will not refuse Medicare or Medicare Advantage from current patients – they wish to continue the relationship. Some doctors may or may not accept new patients, but a study by the Center for Studying Health System Change found that nearly 75% of doctors accepted all or most new Medicare patients in 2008 (Study: Most Physicians Still Accepting Medicare Patients, Fierce Health Finance). How Much Will This Cost Me? First, remember that the State of Georgia is subsidizing your coverage by nearly 75% of the total costs. This is one of the benefits that was “given” to you, so if you were to opt out of the MA plan, it will cost you hundreds of dollars per month for the same coverage. In other words, unless you feel like you have no other option and money to burn, opting out is not an option… (who has money to burn??) The good news about the changes is that it will actually save you money every single month for your coverage. Currently, a PPO covered participant pays $32.90 for single coverage ($142.40 for family). The standard option MAPD PFFS plan will cost $19.30 for single coverage and $38.60 for family coverage (all dependents eligible for MA plan). A mix of eligible and non-eligible Medicare participants in family coverage will have higher costs, but that is to be expected. The premium coverage option for the MAPD PFFS plan will cost $59.30 for a single and $118.60 for a family (all dependents eligible for MA plan). The benefits here are a lower out-of-pocket maximum, lower hospital costs, reduced co-pays, and a better prescription drug benefit. The choice is yours, but weigh the costs by looking at your 2008 and 2009 medical expenditures. The standard plan could cost you more based on your needs… (Check the July 15 letter above to compare the coverages on the Plan Summary enclosure) If you want to check out the retiree rates as set by the SHBP, please click this link to open the PDF. What If I Don’t Choose? According to the information sent with the July 15 letter, “If you are not enrolled in a MAPD PFFS option and do not make an election during the ROCP, your coverage will roll to the MAPD PFFS option of the healthcare vendor you are currently covered. Kaiser members who do not make an election will default to the CIGNA Medicare Access Plus Rx (PFFS) – Standard Plan.” Conclusion Any change is tough to accept in anything… especially medical coverage. The unknown is more of a worry than the known even when it may be better. In five years, few people may even remember this change unless there are real problems. If that starts to happen though, you can almost be assured that the SHBP and its vendors will try to make things right. The State Health Benefit Plan covered 693,716 people as of September 1, 2009, and that is far too big a number to think that they will just accept mediocre results. Try to work with your doctors and try to work with the insurance vendors. The vendors are there to help, so let them help. Both CIGNA and UHC told me that if a doctor is not accepting the plan after you discuss it with them, get the vendor involved. They may be able to help explain it from an ease of use and payment perspective. Just a hint the vendors gave me.
Source: theeducatorsretirement.com

I have a Cigna plan, now what?

What does this mean to you? There is no change for customers during calendar year 2010. ·          There is no visible impact  in 2010. ·          There is no change in benefits or premiums; no one is losing coverage. ·          CIGNA will continue to provide all individual PFFS administration, such as processing enrollments, issuing ID cards and paying claims. ·          No change to contact information. Continue to use the same phone numbers, fax numbers, websites and land addresses to reach the same CIGNA teams as before. So there is nothing for you to do differently yet.
Source: ohiomedicaresupplementcompanies.com

Massachusetts Medical Society Blog

Posted by:  :  Category: Medicare

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For nearly a dozen years, this Sustained Growth Rate formula has called for massive cuts in Medicare reimbursements to physicians.  For each of those years, Congress has stepped in at the eleventh hour to avoid the cuts and provide a modest increase. Yet, for all those years, physicians worried about the viability of their practices and their patients.  And patients, having read and heard media reports about the possibility of physicians abandoning Medicare because of potential cuts in payments, may have wondered if they would continue to have a doctor.
Source: massmed.org

Video: Medicare Supplemental Policy in Massachusetts by Medicare Pathways

ACA Medicare Payroll Tax Costs MA $1.7B Over 10 Years; 3 Patriots to Pay $707,850 in 2013

Pioneer has long held that the healthcare policy conversation in the Commonwealth lacks an informed review of the financial consequences of each provision of the ACA. This brief is part of an ongoing series from Pioneer Institute examining the impact on Massachusetts taxpayers and employers. Recent publications include: “First Do No Harm ‘The Impact of the Affordable Healthcare Act on Massachusetts’ Medical Device Industry,’” April 2013, and “Impact of the Federal Health Law’s ‘Cadillac Insurance Tax’ in Massachusetts,” October 2012. In 2012, Pioneer published a timely book, The Great Experiment: the States, the Feds, and Your Healthcare.
Source: pioneerinstitute.org

Medicare open enrollment: Remember the four C’s

Coverage: Comparing Medicare plans can be simple. The official Medicare website has a tool at www.Medicare.gov/find-a-plan that helps you find and compare all available plans in your area. When reviewing plans, focus on the benefits, such as the coverage offered while you are in the prescription drug doughnut hole, the period during which you pay a higher share of your drug costs. Also, find out which drugs are covered.
Source: fiftyplusadvocate.com

Massachusetts Medicare subscribers save $36.9 million

This statement does not make it clear that it is just as much programs such as Prescription Advantage as seniors that get the so-called savings. I have no problem with the savings, just your wording. But basically there is no reason for anyone in Massachusetts on Medicare, even if making as much as $55,000 in retirement, to be very highly penalized by the donut hole (and again, less than one in 10 are likely to fall into it in the first place)
Source: fiftyplusadvocate.com

ibm medicare options: IBM Extend Health

Doctors rarely “drop out” of original Medicare. They might stop accepting new Medicare patients but if they “drop out” of Medicare it means they have NO Medicare patients. That is a radical decision for a provider if they have a number of Medicare patients.  They’ll likely phase out of Medicare but are unlikely to abruptly stop treating you.   However, doctors often do drop out of MA plans abruptly and it is usually because of how those plans pay them. The MA plans not only might pay providers less than original Medicare but may be slow to pay providers.  When providers  leave HMO plans you can no longer go to the doctor and have to find a new doctor in the HMO.  For other types of MA plans a doctor can stop accepting the MA plan at any time.  So, you might have an MA PPO plan and are being treated for a complex condition by a doctor you trust.  That doctor can decide to not accept your plan any time during your treatment.     
Source: blogspot.com

Ryan’s Medicare Rhetoric Could Hurt in Florida

Start with a person who was born in 1944, began work at age 21, retired at age 65 and enrolled in Medicare. Over the course of his life he paid the Medicare tax out of his wages. According to the 2009 Medicare Trustees Report, the average Medicare benefit per person in 2008 was $11,012. We subtract the average Medicare premium of $1,288 to produce an average net benefit of $9,724. I’ll assume that this person collects the average Medicare benefit from age 65 through age 83 (his life expectancy as of age 65).
Source: thetakeaway.org

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October 04, 2013

Guide to Reporting Medicare Fraud

Posted by:  :  Category: Medicare

What Happens When Reporting Medicare Fraud Medicare fraud can be investigated by a variety of government agencies, the most likely to be the US Attorney Office, the Department of Justice (DOJ), and the Office of Inspector General (OIG) – which is part of the Department of Health and Human Services (HHS). The DOJ agency would be the Federal Bureau of Investigation (FBI). Investigations conducted by the DOJ or US Attorney’s Office are usually in cooperation with the OIG since healthcare fraud abuse and prevention is the responsibility of the HHS/OIG and because of their expertise in healthcare.
Source: all-things-medical-billing.com

Video: Medicaid Fraud Whistleblower Praises His Qui Tam Attorneys

Medicare phone scam targeting local elderly

Connell was very suspicious at this point as his bank information has nothing to do with his Medicare. The man then put another person on the line that repeated the same script, asking Connell to read the numbers on the bottom of his check. The numbers on the bottom of checks contain the account number for the check as well as the bank routing number and check number.
Source: tacticalminc.com

Prescription fraud and me

In all my years of clinical practice, I have never previously been aware that anyone has falsified one or more of my prescriptions. Now I am.  He was a sad and seemingly exhausted young man who said his only problem was intermittent bouts of insomnia. He requested something to help him sleep, but nothing too strong. We talked about sleep hygiene, examined his life — no causes of stress, no depression — and I prescribed an anxiolytic. We had a follow-up consultation and he said he was starting to get back into his normal sleep pattern.  And then came the telephone calls from the pharmacists. He was presenting prescriptions for Schedule 8 drugs on my stationary. I do not know how he…
Source: com.au

How to Report Medicare Fraud

Silver Planet® helps Boomers guide their parents to age in place by offering services and products related to aging at home and housing options. Its Silver Advisors™ are professional geriatric care managers who provide phone consultations to resolve Boomers’ parents aging issues,  such as preventing falls, navigating  Medicare, and assessing seniors’ ability to drive safely, Silver Advisors clarify concerns, help prioritize next steps, and provide personalized written plans and recommendations.
Source: agewiseliving.com

13 Indicted For Medicare Fraud In Puerto Rico; Federal Officials Use Hotline To Find Medicaid Fraud

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.
Source: kaiserhealthnews.org

Hotline Being Used to Combat Medicare Fraud

The hotline was created in 2008 and was largely ineffective due to under staffing. Many complaints regarding fraud went unanswered and phone call were unlikely to be returned. At the cost of millions of dollars, the hotline expanded the operation to include 15 telephone operators and 15 investigators. The operators at the hot line speak both English and Spanish. They are responsible for taking down the beneficiaries information and billing history. Once the information has been collected, the information is passed on to the investigative team for follow-up. The majority of the phone calls are regarding billing mistakes while about 15% are related to unprovided services. If the information is considered related to fraud, it is sent to the investigative team that is headed up by a retired FBI agent.
Source: miamicriminaldefenselawyerblog.com

Seniors Blow the Whistle on Medicare Fraud

A federal report Tuesday spelled out the results of the South Florida calls: $58.6 million in overpayments recovered, $10.7 million in questionable bills not paid, $3 million seized from fraudulent firms, 103 companies booted from Medicare, 106 companies flagged for extra scrutiny, 835 fraud investigations started, and 30 cases referred for prosecution.
Source: hcafnews.com

Medicare Fraud in Home Health Care?

RELATED PAGES: Discover how to Prevent Home Health Care the Wise Way! Medicare may not pay if you are not homebound What are my patient rights and patient responsibilities? Senior Health Care Insurance Options For Home Care How does a Physical Therapist Pay Structure Affect My Quality of Care? Do I Need Home Health Care? Brag About Your Agency! Thank Your PT! How does a home care agency get paid? Home care business and Medicare fraud
Source: home-health-care-physical-therapy.com

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October 04, 2013

Bigger Deductible Medicare Solution Plan F Duquel Buy It!

Posted by:  :  Category: Medicare

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Although working in an actual hospital, we came across quite a few patients the people that had terminal problem. Most along with them included cancer cells patients who had less than about 6 months with regard to live. Quite a number of patients were located in a lot of pain and directly on top of they know the straightforward fact that death most certainly arrive shortly. Such patients and after that their families acquired offered an idea of hospice. Many patients yet their families did opt for surgery. This cured ease their tenderness to some level and live in the market to the fullest. I am indeed there may sometimes be many such guys who must try to be wondering what this hospice is. If you likewise are one associated these people, then read on and therefore understand the ordinary facts and fictions about this service.
Source: circusfiremen.com

Video: Plan F Medicare Supplements

Anthem High Deductible F Supplement

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 Will Medicare Pay Up For Adjustable Air Mattresses

It is however, advised that the person going to acquire a medigap plan f deal should study the sale documents of all of the Medigap plans one does a decision. All the twelve Medigap policies protect the basic benefits, but each an individual has some additional beneficial properties along with all of them with. In brief it can be mentioned that the Plan A trustworthy is the most straightforward plan. However the Plans B-L has got all the advantages of Plan A yet along with they provide some extra coverage. I would say the Plans K-L has got the benefits further to Plans A-J, but the divergence is the cost-sharing for the fundamental benefits which varies at different levels.
Source: livelovelennon.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

Is AARP The Best Carrier For Plan F?

Medicare supplement insurance plans are basic health insurance policies that are sold to consumers via private insurance companies.  These plans help to cover some of the out-of-pocket costs associated with medical expenses.  The AARP Medicare Supplement for Plan F is designed to help pay for some or all of the expenses that the original Medicare does not pay for – such things as coinsurance, office fees, and deductibles.  You should go over the Plan F details before you decide to find out if you are gaining privilege to all the possible benefits of the plan.
Source: recruitingblogs.com

Original Medicare vs. Medigap: Which is Right for You

Unlike Medicare Advantage and Medicare Part D, which have the same enrollment period called the Annual Enrollment Period (from October 15 to December 7 each year), Medicare Supplement Insurance has its own enrollment period. It spans six months and begins the month that you turn 65 and have Medicare Part B. This is the optimal time to join a plan because you do not have to submit to Medical Underwriting, which is when your medical history is reviewed and you can be charged more for insurance or even be declined coverage.
Source: ehealthmedicare.com

Information About Medicare Supplements

Medicare supplement Plan F is the most popular and helps pay for the co-insurance costs of Medicare Part A and Part B. Plan F also covers 365 hospital days after Medicare is used to its maximum amount of coverage. Medicare Part B is also covered by Plan F. Plan F pays for up to three pints of blood whenever it is needed and it also covers any excess Part B costs. Plan F is especially desirable because it covers emergency services when a policyholder travels abroad.
Source: fishbowlamerica.com

Medicare Supplement Plan J

Insurance agents and company representatives across the country are telling people who have Medicare Supplement Plan J they will be grandfathered in if they purchase Medicare Supplement Plan J before June 1st, 2010. This implies they will be entitled to the identical benefits and will have the alike price, which couldnt be and from the truth. People who have Medicare Supplement Plan J will not always have the twin price, and their benefits will be cut. What is happening? Medicare is eliminating two benefits from all Medicare Supplement Plans, which are At Home Recovery and Preventive Care. At Home Recovery was a benefit that covered $40 for forty days of care at home and preventive care was an annual $125 benefit. With the elimination of these two benefits Medicare is being forced to eliminate Medicare Supplement Plans E, H, I, and J. The instigation these plans are being eliminated is for they would be causeless with other plans that are contemporaneous offered. For example, with the elimination of these two benefits, Medicare Supplement Plan J and Medicare Supplement Plan F will be exactly the twin, which is why Plan J is being eliminated. Why is it happening? Medicare is eliminating these two benefits whereas they were infrequently used by Medicare recipients. Medicare must approve all expenses and benefits and they halfway never approved the At Home Recovery Benefit, recital it abortive. The preventive care benefit will be eliminated since doctors code things agnate annual physicals as routine visits instead of preventive care. Most preventive care visits will still be covered, especially with the addition of the new health care reform bill just signed into law by President Obama. Can you keep these benefits if you have Plan J? No, you can not keep these benefits if you keep Plan J because Medicare is eliminating the benefits and will not approve the expenses. Medicare Supplement Plansare minor in nitty-gritty with Medicare being your primary insurance. If Medicare doesnt pay, then your Medicare Supplement Plan will not pick up the remaining cost. The only thing that will be grandfathered if you have Plan J will be the name Plan J “. Other than the name, you will have the exact twin benefits and Medicare Supplement Plan F. What happens if you have Plan J? If you have plan J, you can keep it if you near or you can stud to innumerable Medicare supplement Plan and try to save money. If you thirst to boss to one of the newMedicare Supplement Plans according to as Plan N or Plan M, you may qualify for a guaranteed subject period which means you will not have to answer any health questions and will be accepted into the new plan regardless of any pre – existing health conditions. However, if you pleasure to keep a comprehensive plan compatible as Medicare Supplement Plan F, you will be required to answer a series of easy health questions monastic to being approved. However, if you are in good health you will likely be able to save lot of money. Medicare Supplement Plansare very important for seniors regardless of whether they are in great health or have several health issues as we can never feature when anyone may need medical or hospital services. This can be an excellent time to compare all plans and companies to make rank you have a good comprehensive plan and are getting the best price available. Consulting an expert can make this process very easy and can answer all your questions within a few chronology.
Source: blogspot.com

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October 04, 2013

Where are States Today? Medicaid and CHIP Eligibility Levels for Children and Non

Posted by:  :  Category: Medicare

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The Affordable Care Act (ACA) creates new coverage options through Medicaid and new health insurance exchange marketplaces that, taken together, provide assistance to individuals with family incomes up to 400% of the federal poverty level (FPL). The ACA calls for the expansion of Medicaid eligibility to 138% FPL ($15,856 for an individual or $26,951 for a family of three in 2013) in 2014, which would make millions of adults newly eligible for the program. However, this expansion was effectively made a state option by the Supreme Court. If a state does not expand Medicaid, low-income uninsured adults in that state will not gain that new coverage option and will likely remain uninsured. This brief provides an overview of current Medicaid and CHIP eligibility levels for non-disabled children and adults to provide better insight into the impact of the Medicaid expansion.
Source: kff.org

Video: Medicare vs Medicaid 612-309-9184 Minnesota Medical Assistance Minneapolis Elder Law Attorney

Medicare Power Wheelchair Coverage Guidelines

When a patient calls in to Aeroflow to get the process of getting a power wheel chair or scooter started, we ask some preliminary questions. To get a power mobility device it must be a necessary alternative to manual devices like a cane or walker, so we ask if they have a history of using assistive equipment or not. If a patient has not used these devices, it is suggested that they attempt using them or a manual wheel chair prior to a power chair. A cane, walker, and manual wheel chair all must be ruled out by a doctor as insufficient for the patient to complete their activities of daily living inside the home. These activities include cooking, cleaning, moving from room to room, and grooming.
Source: aeroflowinc.com

Medicare penalties to cost some Fayetteville, region hospitals

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Source: fayobserver.com

OIG Report Examines Critical Access Hospital Qualifications : Health Industry Washington Watch

Almost two-thirds of critical access hospitals (CAHs) would not meet Medicare CAH location requirements if they were required to re-enroll today, according to the OIG. Many of these rural hospitals were permanently exempted from CAH distance requirements under previous authority of states to designate “necessary provider” (NP) CAHs. Medicare reimburses CAHs at 101% of their reasonable costs; if CMS had the authority to decertify CAHs that were 15 or fewer miles from their nearest hospitals in 2011, the OIG estimates that Medicare would have saved $449 million. The OIG recommends that CMS take several steps to “ensure that the only CAHs to remain certified would be those that serve beneficiaries who would otherwise be unable to reasonably access hospital services.” For instance, the OIG recommends that CMS seek legislative authority to remove NP CAHs’ permanent exemption from the distance requirement; CMS notes that the President’s proposed FY 2014 budget would decertify any CAHs located fewer than 10 miles from another hospital or CAH (and reduce payment to all remaining CAHs to 100% of reasonable cost). CMS also discusses steps it has already taken to implement OIG recommendations to periodically reassess CAHs for compliance with all location-related requirements and to ensure that CMS applies a uniform definition of “mountainous terrain” to all CAHs. CMS disagreed with an OIG recommendation to seek legislative authority to revise the CAH Conditions of Participation to include alternative location-related requirements.
Source: healthindustrywashingtonwatch.com

Medicare Eligibility Requirements

Note: You can qualify for Medicare on your spouse’s work record if he or she is at least age 62 and you are at least age 65. You also may qualify on the work record of a divorced or deceased spouse. Following the Supreme Court’s ruling on the Defense of Marriage Act in June 2013, people in same-sex marriages may qualify on their spouse’s work record if they live in the state where they were wed or in another state that recognizes same-sex marriage, or if they are civilian or military employees of the federal government. It’s currently unclear whether same-sex couples outside of these categories have the same rights — but if you’re in this position, you should apply anyway.
Source: aarp.org

Settlement May Bring Easier Qualifications for Medicare

The Medicare board has had a longstanding practice to require a likelihood of medical or functional improvement before a beneficiary could receive coverage for skilled nursing or therapy services, whether institutional or home-based. That left many care recipients in a lurch. If this settlement goes through and becomes practice, then the requirement is no longer “improvement” but “maintenance.” Accordingly, Medicare will provide services if they are needed to “maintain the patient’s current condition or prevent or slow further deterioration.”
Source: estateplanningaustintexas.com

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October 04, 2013

Medicare And “Marketplace Plans” In Torrance, California

Posted by:  :  Category: Medicare

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Problem: Medicare Part A is free for most beneficiaries and goes toward hospitalization and limited nursing home care. Since this fulfills the insurance requirements set by law, those on Medicare do not need anything in addition. For some 20-odd years it has been illegal for private insurers to try and sell their plans to individuals known to be Medicare recipients. This is the result of an effort to keep insurers from taking advantage of Medicare recipients.
Source: southbayelderlaw.com

Video: California Medicare Advantage Plans – Advantage Plan Comparisons

SECOND HIGHEST CHIROPRACTIC MEDICARE BILLER IN CALIFORNIA PLEADS GUILTY TO HEALTH CARE FRAUD

arson assault attempted murder bank fraud bank robbery bribery burglary child abuse child pornography child sexual assault conspiracy drugs drug trafficking DWI embezzlement firearm fraud gang grand theft gun identity theft illegal pornography insurance fraud investment fraud kidnapping knife lewd acts mail fraud manslaughter medicare fraud money laundering mortgage fraud murder PERJURY public corruption rape robbery sexual assault sexual battery shooting stabbing tax fraud theft vehicular manslaughter wire fraud
Source: bestdefender.com

Humana Hires Brown to Lead California Medicare Operations

Humana Inc., headquartered in Louisville, Ky., is a leading consumer-focused health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Source: distilnfo.com

Medicare Contractor Changes in California, Nevada, and Hawaii – September, 16, 2013

The good news for our clients is that they do not need to make ANY changes in their Payer Setup to accommodate this change. Our clearinghouse, Capario, is managing this transition. They have done all appropriate testing, and all the necessary changes will be made at the clearinghouse. Nothing needs to be done within OfficeEMR. This should be a seamless transition for our clients.
Source: isalushealthcare.com

Veteran prosecutor describes SoCal as ‘epicenter’ of Medicare fraud

Guv Brown is releasing rapists and perverts from prison after serving only 40% of their sentences.  In LA County if a male is given a 90 jail term or less, or a woman a 240 day jail term or less, they are immediately released, no time served.  In California being a criminal is no longer a problem—just ask the millions of illegal aliens roaming our streets, taking our jobs, filling up classrooms and hospital beds.  We are a tolerant people. Maybe that is why we are also the HQ for Medicare fraud.  People don’t see stealing from government is theft.
Source: capoliticalnews.com

My Sister Has Relocated to California. Can She Change Her Medicare Insurance Coverage?

If the beneficiary is already on a Medicare supplement plan and wishes to keep it, s/he should find out from the plan what their premium would be in their new region and/or state to determine if they should keep that carrier or change to another carrier in their new location whose premium for the same plan (with the same benefits) is lower.
Source: personalmedicareadvisor.com

What Is California Medicare?

These days, prescription drugs can be very expensive, especially those to do with cancer, and new ones based on RNA. This plan is a monthly premium, and covers virtually all prescription drugs. With a number of these plans available, it is worth checking what is covered before buying. For people not interested in any of the above California Medicare plans, then this one for prescription drugs can be taken out on its own.
Source: med-screen.com

One Can Be Fully Benifited by California Medicare

The California is one among the richest state in the USA and unlike other state, god blessed America and California more. The people living in California have show great interest in the health and maximum all the adult and minors will take the Medicare plan compulsorily, the California Medicare advantage have greater volume of interest among the many insurer. People know about the benefits of taking Medicare plans. It is the right of every citizen living in the California takes Medicare plan and they don’t have the idea when the danger strikes in force. They must plan for everything in advance. Many times people are made confused to select the best Medicare plans available in the state by others and different other companies. It is because of one genuine reasons many people among them who don’t have the clear idea what is the Medicare plan is all about and One would take ideas from the non-expertise people who may give bad answers or show the wrong path to do so. The California Medicare advantage would give the best plan about what the Medicare plan is all about and also helps to take the best advantage plan available in the files. The insurer have the choice taking Medicare plan and it gives with the three benefits for the respectively. The three plans will be under the categories of the parts like A, B, C and D. the part A and B discuss about the unique Medicare and that begins from them with the date that one has joined in the Medicare card and the part C discuss about the advantage of taking the Medicare plans and the part D discuss about the California Medicare supplement. The California Medicare advantage is recommended for the person who is more adult enough in the market and unable to solve the medical expenses in the more early ages. It is necessary to take care of the health because it has its own advantage, to the person who is above the age of 65 years old or more than that. About California Medicare Plans It is being served for the best among the market in the areas of Medicare plans for the people living in the California. To make contact online log on to http://www.4californiamedicareplans.com/ For more details One may contact: Jeff White info@4californiamedicareplans.com 1235 N Blue Gum Anaheim, CA 82806 888-806-3299
Source: sbwire.com

California Medicare Coalition, CMC Meetings

Presenters: Elaine Wong Eakin, Executive Director, California Health Advocates, and Amber Cutler, Staff Attorney, National Senior Citizens Law Center Amber discusses the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration project, known as Cal MediConnect. Her discussion includes: what is the CCI; who is affected by the CCI; how beneficiaries are affected; how enrollment works; and how to get involved in the CCI. View Webinar Download the Webinar slides
Source: cahealthadvocates.org

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October 04, 2013

Medicare Cuts and How it Effects Seniors

Posted by:  :  Category: Medicare

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This new Healthcare bill targets seniors. People who have worked their entire life and contributed with taxes now face an uncertain future concerning health care. The family of the elderly will be saddled with dept from long-term care for senior family members. Once implemented, this plan will cause economic and emotional hardship for millions of Americans, Healthcare needs reform, but not at the expense of our most cherished class of citizen, the elderly.
Source: suite101.com

Video: Looming Catastrophic Medicare Cuts (Horizon, Ch. 8, AZ PBS- Nov. 17., 2010)

FAQ: Seniors On Medicare Don’t Need To Apply To The Health Law Marketplaces

Some worry those cuts could lead to access problems, if providers drop out of the program. In the most recent Medicare Trustees report, Paul Spitalnic, then acting chief actuary for the Centers for Medicare and Medicaid Services, wrote that over the long term, some of the health law’s changes would cause Medicare payment rates for home health, hospital and other services to drop below those now paid by the Medicaid program, “which have already led to access problems for Medicaid enrollees.”
Source: kaiserhealthnews.org

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

US shutdown a smokescreen for assault on Social Security, Medicare

The partial or total shutdown of most departments other than the uniformed military and police/intelligence agencies such as the CIA, the FBI and Homeland Security is hitting broad layers of the population. Besides the closure of national parks and monuments, some 8.9 million low-income mothers and children are being denied food aid due to the shutdown of the WIC program; pension and veterans’ benefit checks are being delayed; preschool Head Start programs are closing; sick people, including cancer patients, are being turned away from National Institutes of Health clinical trials; and foster care payments, nutrition aid and financial assistance for hundreds of thousands of Native Americans are being halted.
Source: greanvillepost.com

Medicare Cuts, Obamacare Prompt Hospital Layoffs

“The sheer magnitude of the Medicare and Medicaid cuts impel us to look at all of our services and costs, including the largest component of our budget—personnel,” Cummings said, citing a 20 percent cut in Medicaid proposed by Democratic Gov. Dannel Malloy and approved by the state legislature resulting in a $550 million hit to Connecticut hospitals. Sequestration also resulted in an additional $1 million loss for L + M this year.
Source: freebeacon.com

New AMIC Survey Data Shows 2010 Medicare Payment Cuts Forcing Physician Practices and Imaging Providers to Reduce Patient

In the past, the Obama Administration has proposed using RBMs in the Medicare program.  However, the Department of Health and Human Services (HHS)  previously weighed in on prior authorization in the Medicare program, noting in 2008 that a prior authorization program could be “inconsistent with the public nature of the Medicare program,” since such programs rely on private companies using proprietary systems to deny care prescribed by a physician.  HHS also noted that the Medicare appeals process guaranteed to every beneficiary could overturn a “high proportion” of denials, rendering the policy ineffective.  In an environment of reduced reimbursements, the AMIC survey further demonstrates that application of RBMs is an ineffective model imposing unnecessary administrative costs on practices, thereby creating artificial barriers for patients in need of care.
Source: rightscanrighttime.org

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October 04, 2013

How and when to sign up for Medicare

Posted by:  :  Category: Medicare

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If you are eligible, you have the choice of accepting or rejecting Part B coverage. If you want Medicare Part A and Medicare Part B, then you should sign your Medicare card and keep it in your wallet. If you don’t want Part B, you put an “X” in the refusal box on the back of the Medicare card form, and send the form to the address shown right below where your signature goes. About four weeks later, you will get a new Medicare card indicating that you only have Part A coverage.3
Source: stillwatergazette.com

Video: How To Compare 2014 Medicare Advantage Plans

A Look At Services Affected By The Federal Gov’t Shutdown

WHAT CLOSES: * Any federal agency that’s subject to appropriations. Each agency has the discretion to decide who is “excepted” or “emergency”, and who is furloughed. * All National Parks. * All federally-funded museums, including Smithsonian and the National Zoo. * All federal government websites. * Research by Health and Human Services stops. So does the grant process. Depending on how long it lasts, that will also impact medical research at hospitals and universities. * Applying for Social Security. If you’re a new retiree, your application won’t be processed. * IRS walk-in centers. Your paper tax return will not be processed. * Loan applications for small businesses, college tuition, or mortgages. * All Library of Congress buildings. All public events will be cancelled and web sites will be inaccessible. * Federal contractors will be out of work. * Federal workers (except “excepted” or “emergency” personnel) will not be allowed to work, not even from home. No blackberry, no smartphone, no laptop. Not even allowed to check work email.
Source: cbslocal.com

How Does Obamacare Affect Medicare?

The myth about Obamacare ending Medicare is entirely false, as Nicole Duritz, vice president of Health Education and Outreach with the American Association of Retired Persons (AARP), explained to U.S. News and World Report. If anything, “Medicare’s guaranteed benefits are protected in ways that they hadn’t been protected in the past” under the Patient Protection and Affordable Care Act, Duritz said.
Source: findlaw.com

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