Medicare Drug Plan Polls Suggest Bright Future for Obamacare

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



Looking back on it, the public’s turnaround from initial rejection to growing support for Part D was understandable. The unfunded $400 billion program that President Bush signed into law in December 2003 was needlessly complex for seniors and unnecessarily expensive for taxpayers. Rather than having the government negotiate prices directly with pharmaceutical firms and add drug coverage into the traditional Medicare program, President Bush and his Republican allies in Congress instead gave recipients subsidies to purchase plans from private insurers. Making matters worse, millions of “dual eligible” already receiving drug coverage from Medicaid had to switch to the new scheme, a process that left millions unable to pay for their prescriptions for weeks in early 2006.
Source: crooksandliars.com

Video: Parts of Medicare

How and when to sign up for Medicare

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

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: kaiserhealthnews.org

Do I Have to Pay for Medicare Part A?

Home health services: This covers eligible home health services like intermittent skilled nursing care, physical therapy, speech-language pathology services, continued occupational services, and more. Your cost: $0 for home health care services, plus 20% of the Medicare-approved amount* for durable medical equipment. Do note that Medicare doesn’t pay for 24-hour-a-day care at home, meals delivered to your home, homemaking services, or personal care. 
Source: ehealthmedicare.com

Medicare Part D: Another Year, Another Huge Price Increase

Chart 10 from the Kaiser Family Foundation (scroll down). Notice that the U.S. government spends about as much of its GDP on healthcare as other developed countries (without, however, insuring everybody, as the other countries do). Notice that, unlike citizens of other countries, U.S. citizens spend a whopping amount in addition to what the government spends. The difference? Those other countries put strict limits on what pharmaceutical companies and other medical suppliers can charge.
Source: sojo.net

Healthy Outlook for Medicare Advantage and Part D from CMS in 2014

Last week amid all the ObamaCare drama on the Hill CMS released the 2014 data for Medicare Advantage (MA) and Prescription Drug Plan (PDP) bids. The numbers show a better-than-expected 2013 and a healthy 2014 ahead for Medicare health plans.  The market will see new service areas, lower bids, more zero premium plans, and more mainstreaming of Medicare Advantage as it approaches one-third of the program. CMS noted significant gains on plan quality measures, pointing out that more plans are receiving a rank of four -plus on Star Ratings, the minimum threshold for quality bonuses in 2015 when the quality demonstration expires.  Overall there is clear evidence that CMS quality incentives are working, and that MA will continue its steady ~10% growth in 2014.
Source: gormanhealthgroup.com

Medicare Compliance… It’s Not Just for Workers’ Compensation Anymore

It is well known that where the parties to a workers’ compensation claim settle their case, Medicare’s future interest has to be considered if the claimant is a Medicare beneficiary; the Centers for Medicare and Medicaid Services (CMS) have an approval process for Medicare Set Asides (MSAs) in these cases. Those guidelines are as follows: where a party to a settlement is (a) Medicare enrolled and the settlement is greater than $25,000, or (b) has a reasonable expectation of Medicare enrollment within 30 months (i.e. is on Social Security Disability or is at least 62.5 years old) and the settlement is greater than $250,000, CMS will entertain an application to review a proposed MSA. These guidelines have sometimes been interpreted to mean that where neither of those two conditions apply, no MSA is necessary. This is not necessarily the case; the guidelines only indicate that CMS will not review an MSA application in those situations. It does not grant safe harbor to any settlement that does not meet those criteria. The overarching requirement is still that Medicare’s future interests be considered. Given that CMS may sue any party to a settlement for failure to consider their future interest (including counsel), good practice dictates making a reasonable effort to consider Medicare’s future interest even where there may not be an immediate expectation of liability potentially being shifted to Medicare. 
Source: gsriskmitigationblog.com

Medicare Part D Is Working

The American Action Forum released a report Thursday finding the Medicare Part D program has been successful in its first ten years, with significantly lower government expenditures than projected, low beneficiary costs, and high customer satisfaction, according to an AAF release.
Source: freebeacon.com

Tax Medicare Benefits or require beneficiaries to pay 50% of Part B costs rather than 25%

The chart of taxes paid versus benefits received is based on people retiring in 2030. We are not quite there yet but on average, people get more than they pay for from medicare. There is no doubt that in their present form, both social security and especially medicare are fiscal failures due to their Ponzi like structures and lack of legislative will to make necessary actuarial changes in a timely manner. The fact that the average “Joe citizen “doesn’t understand or take the time to educate themselves on the economics of the system doesn’t help the situation either. This country needs to go back to the drawing board and entirely revamp the tax code and all its loopholes, expenditures and preferences while at the same time getting a grip on entitlements. Anything short of this will just be putting rubber bands and sealing wax on a terribly flawed system. A perfect example of this is fixing a health care system with Obamacare. Do I think any of this might happen in the near future? That’s an unqualified NO, not with the current state of politics but if it doesn’t happen eventually, government shut downs and debt limit fights will seem like a walk in the park.
Source: quinnscommentary.com

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

Michigan and Illinois Get Two Medicaid Systems for the Price of One

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



Under federal law, every state must operate technology to support backend administrative functions of their Medicaid programs. Around the country, states are racing to modernize their legacy systems as they prepare for the expansion of Medicaid under the Affordable Care Act. The feds are offering to fund 90 percent of MMIS upgrades and, according to a survey by the National Association of State Chief Information Officers, 78 percent of state CIOs said they expect to modernize their MMIS by 2014.
Source: governing.com

Video: Introducing the Illinois Medicare-Medicaid Alignment Initiative

Illinois’ Medicaid Scandal

These whistleblowers tell National Review that when Client Network Services, Inc., was seeking the Medicaid contract, it wined and dined state officials, who then circumvented Illinois’s standard procurement procedures in order to outsource the multimillion-dollar contract to CNSI, which is currently under criminal investigation in Louisiana. CNSI, headquartered in Maryland, has a history of work of questionable quality, overrun project budgets, delays, and litigation in several other states.
Source: typepad.com

Illinois Retired Teachers Association President Gary Elmen addresses TRIP and Medicare issues.

At the recent TRIP committee meeting when the new Medicare Advantage plan was mentioned, there were no significant details. CMS will release those later, even though they must know some parameters because of the bid solicitation. But given the changes this year in copays/deductibles (e.g. Cigna) that confused retirees and prompted many calls to CMS, it is not surprising that CMS wants to have their act together.
Source: wordpress.com

National Review: Illinois’s Medicaid Scandal by Jillian Kay Melchior

National Review’s interviews with whistleblowers also raise questions about the working relationship between Illinois officials and CNSI. A source close to the upgrade project says the HFS’s chief information officer, Stephen DePooter, and others on the team have corresponded copiously with CNSI, sometimes sharing information that would give the company an unfair advantage. The whistleblower said DePooter was one of the key people gunning for the collaboration with Michigan and CNSI. And e-mails obtained through a public-records request appear to show that DePooter coached CNSI on how to respond to CMS, which must sign off on the project at the federal level. HFS says the project did not receive federal CMS approval until May 2013.
Source: forthegoodofillinois.org

Activists Want An Immediate End To Illinois' Medicaid Privatization Contract

The approximately 20 activists at today’s protest say the Maximus contract causes unjust Medicaid disqualifications, violates workers’ rights and costs the state more than if the job were done in-house. They called on Gov. Pat Quinn and HFS Director Julie Hamos to end the contract now, asking that the officials not wait until December 31 to fire Maximus. Quinn’s administration has not yet said if it would appeal the arbitrator’s ruling in court, or bring on the 100 extra state workers needed to cover the job Maximus is doing. According to AFSCME, the state would save $18 million a year by having public employees do the work instead of shelling out $76 million for a two-year contract with Maximus.
Source: progressillinois.com

Extra: UnitedHealthcare Snags $3.6 Billion Illinois Health Care Contract

CMS had announced in June that it was seeking offers for a nationwide Medicare Advantage PPO plan with prescription drug coverage, and/or Medicare Advantage HMO plan(s) with prescription drug coverage, and/or a nationwide group Medicare Supplement plan and Medicare Prescription Drug Plan (PDP) for Medicare-eligible retirees and their eligible dependents.
Source: illinoisobserver.net

New Insurance Exchanges Confuse Illinois Elders / Public News Service

CHICAGO – October will be an important month for health care in Illinois and around the nation. Beginning October 1, people without health insurance will be able to sign up for coverage through new online health exchanges. However, according to associate state director Courtney Hedderman of AARP Illinois, all the publicity about the exchanges is confusing people who need Medicare. “People are seeing those messages, like, ‘Wait, do I need to do something?’ And they don’t,” she said. “That has nothing to do with Medicare.” The problem is that on October 1 the online exchanges open, and then on October 15 the Medicare open-enrollment period begins. That’s why Medicare is sending out thousands of brochures and training counselors to advise elders in Illinois and around the nation to ignore the online health exchanges. Instead, if they want to make changes or sign up for Medicare, they should contact the Department on Aging, their local Social Security office, or go to Medicare.gov to find a counselor who can advise them. Hedderman said con artists already have started trying to take advantage of the confusion by doing things like calling on the phone and pretending to be from Medicare or Social Security. “People were calling, and they’re saying, ‘This is Medicare calling, and we need your Social Security number.’ No, they already have your Social Security number,” the AARP official said. “You don’t need to be giving that.” During the open-enrollment period that starts October 15, Medicare recipients can review or change their supplemental coverage through the many counselors who are not trying to sell anything. “If someone lives in the city, for example, they can call 311 and they will be connected to the Department on Aging. That’s a trusted entity that has counselors that can help navigate all of this.” Hedderman said to remember that SHIP counselors are trained to help elders figure out Medicare. The acronym SHIP stands for the State Health Insurance Program, which offers free counseling for Medicare recipients and their caregivers through the Illinois Department on Aging. Illinoisans who are about to turn 65 should contact their local Social Security office to sign up for Medicare. They need to do that three months before their birthday because if they sign up later than that, unless they have other coverage, they may be charged higher premiums. More information is at Medicare.gov and at state.il.us.
Source: publicnewsservice.org

Chicago Hospice Services: Who Pays For Hospice Care In Illinois?

Medicare—If a person is terminally ill and is a Medicare beneficiary using a Medicare-certified hospice provider, 100 percent of hospice services are covered. In 2011, 84.1 percent of hospice patients were covered by the Medicare hospice benefit. Hospice payments are separate from Medicare payments for other illnesses, diseases or care the patient may be receiving.
Source: cbslocal.com

Will County Illinois Medicare Supplement Quotes

Tagged With: Aflac Medicare, Bache, Cigna Medicare, Illiinois Medicare, Medicare, Medicare Quotes, MedicareBob, Medigap, Robert Bache, Senior Healthcare Direct, Will County Medicare Supplement Insurance, www.SrHealthcareDirect.com
Source: srhealthcaredirect.com

Beware of scams as Affordable Care Act is rolled out, Attorney General Madigan warns

• Guard your personal information. Do not give out your Social Security number, bank account number, or other sensitive personal or financial information to someone who calls you, e-mails you or comes to your door. However, be aware that when you enroll for an insurance plan through the Health Insurance Marketplace, you will be asked to provide your Social Security number and payment information, among other personal information. Before you do this, make sure you are on the official website, and if you sign up in person, ask the specialist who is helping you to look away while you enter this information online.
Source: rockrivertimes.com

Medicare Advantage: The canary in the coal mine

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



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: social security retirement benefits.social security retirement age.my social security benefits

cherry creek towers: replacing medicare card BLACK CORAL REEF. This dive site is 40

BLACK CORAL REEF. This dive site is 40-70 feet below the surface and is best known for its protected black coral. BLOODY BAY REEF. At 60-80 feet, this dive site is noted for its healthy undersea life, from anemones to sea fans. It s a popular fishing site as well, and an occasional shark is seen here, the result of chumming. Divers will find several caves in this area. THE CAVES. Just off the coast of Charlestown lies this undersea adventure, a series of coral grottos that invite exploration. replacing medicare card Marine life is plentiful along this shallow 40-foot dive and there are plenty of squirrel fish, lobster, sponges and an array of corals. COCONUT TREE REEF. A variety of dive experiences, from beginner to advanced, are available on this reef, which starts at 40 feet below the surface before plunging to over 200 feet. Beautiful corals and bountiful marine replacing medicare card life are found here. GRID IRON. Found in the channel between St. Kitts and Nevis, this dive follows an undersea shelf. Look for angelfish as well as rich aquatic life on this dive. MONKEY REEF. You won’t see any monkeys down here, but plenty of other life awaits: nurse sharks, stingrays, lobster and more. This is a shallow dive, approximately 50 feet below the surface replacing medicare card off the Southeast Peninsula. NAGS HEAD. This advanced dive is found where the calm Caribbean Sea meets the more rugged waters of the Atlantic Ocean. The result is a strong current and rich marine Taxi Service Taxis are not just the best way to get around, they’re about the only way. Don’t look for rental cars on this island. Usually a taxi comes to meet the plane at every landing and can take you anywhere you’d like to go.
Source: blogspot.com

Florida Elder Law and Estate Planning: Alert to Medicare beneficiaries: Ignore scammers pitching marketplace plans!

If you are 65 and older and receiving Medicare benefits, forget about the Affordable Care Act and the new marketplace insurance exchanges. You do NOT need to purchase new coverage through your state’s insurance marketplace. Says Richard Olague, spokesman for the Centers for Medicare and Medicaid Services: “We want to reassure Medicare beneficiaries that they are already covered, that their benefits aren’t changing and that the marketplace doesn’t require them to do anything different. Specifically, they do not have to change their Medicare coverage or enroll in any marketplace plan.”
Source: blogspot.com

Federal Government Shutdown Impact on VA Benefits and Social Security

Jerold E. Rothkoff, a practicing New Jersey and Pennsylvania attorney, is the Principal of the Rothkoff Law Group, and elder care law firm. Jerry dedicates his practice to serving clients in the areas of life care planning, long-term care planning, Medicaid & VA benefits, and advocacy for the elderly and disabled. He is current President of the NJ Chapter of the National Academy of Elder Law Attorneys, and Past President of the Life Care Planning Law Firm Association. Jerry continues to be an outspoken advocate for the rights of the elderly and disabled. He writes for and gives presentations regularly to attorneys and other professionals about legal issues related to seniors and those with disabilities. Jerry’s community activities include Twilight Wish Foundation, the Delaware Valley Stroke Council, the Alzheimer’s Association, as well as numerous other advocacy groups. When not in the office Jerry spends time with his wife, Erica, and five children, fifteen-year old identical twin girls, Liza and Julia, twelve-year old fraternal twin boys, Evan and Gregory, and three-year old Aitan.
Source: rothkofflaw.com

Smart Card Proposal Looks to Reduce Medicare Fraud

Under this proposal, no external information would be printed on the card (like Medicare numbers are today). Instead, a user’s data would be housed on an internal data chip. Card readers would be installed at participating areas for all services, and a beneficiary would swipe their card in order to receive any Medicare-related amenity. This would create an electronic record of the transaction, which would then allow for easier monitoring and investigation into any alleged instances of Medicare fraud.
Source: ehealthmedicare.com

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

lost social security card nyc: replacing a medicare card Gardens: Franciscan Garden (Prague), 81; F rstenberg Gardens (Prague), 114; Konopi t Castle, 172; Kr

Gardens: Franciscan Garden (Prague), replacing a medicare card 81; F rstenberg Gardens (Prague), 114; Konopi t Castle, 172; Kr lovsk Zahrada (Royal replacing a medicare card Gardens, Prague), 100; Krom Castle Garden, 246; Krumlov Castle, 190; Na ValechGarden (Prague), 114; P lffy Gardens (Prague), 114; StrahovMonastery garden (Prague), 101; Vrtba Garden (Prague), 94; Wallenstein Palace Garden (Prague), 91 94 Centuries ago, this thinly populated replacing a medicare card borderland betweenBohemia, Moravia, and Austria was filled with thieves and thugs and was, therefore, nearly impossible to tax. Founded in the 1200s, the town was originally named Zlabings by the German settlersinvited to colonize and civilize replacing a medicare card the region. replacing a medicare card has an original Gothic replacing a medicare card vault, but its Gothic treasures are in aPrague museum. replacing a medicare card The altar and windows, while lovely, are Neo- Gothic, dating only from the 19th century. Climb the 200 steps to the tower to enjoy a commanding city view (15 K ).
Source: blogspot.com

Comments Off  :  Add Comment
October 06, 2013

Understanding Medicare Part A, Part B, Part C and Part D

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



But as complicated as all that sounds, there’s a single key choice at the core of all your decision-making: Will you go with the Original Medicare plan, which is run by the federal government and consists of Parts A and B, or a Medicare Advantage plan (also called Part C) that is offered by a private insurer and approved by Medicare? Medicare Part A — Your Hospital Coverage When you apply to Medicare, you are automatically enrolled in the Part A plan. Part A is your hospital insurance plan. It covers nursing care and hospital stays, although not doctors’ fees. Part A also covers some home health services, skilled nursing care after a hospital stay and hospice care. You likely won’t have to pay a monthly premium for Medicare Part A, thanks in part to all the payroll taxes you paid while you were employed. You must, however, pay a yearly deductible before Medicare will cover any hospitalization costs. For 2011, the Part A deductible is $1,132.
Source: aarp.org

Video: Medicare Part A, B, C and D Explained

The ABCD’s of Medicare

Part D Tip: Each year since 2010, the donut hole amount has been reduced by 10%. It will continue to go down 10% each year until it disappears in 2020. Then, you will only pay your normal 25% coinsurance after you reach your deductible. Coinsurance means Medicare pays 75%, you pay 25%. Since it’s 2012, and you still have a donut hole, the government has negotiated with brand name drug manufacturers to offer 50% off some prescriptions. Check with your local pharmacy to see if the discount applies to your medications.
Source: hoopayz.com

The A, B, C’s, and D’s! of Medicare

Helping You Understand Your Medicare Benefits and Other Plans Many people expect to kick back and relax from budgeting during retirement years. With skyrocketing healthcare costs, it’s important that older Americans understand their Medicare benefits, the role of additional insurance, and the coordination of any other health insurance plans. Use the resources available from your doctor to understand how to take advantage of your Medicare benefits and keep your out-of-pocket expenses to a minimum. The knowledgeable team at AlphaMed is also happy to guide you in the right direction. If you have a parent that is nearing 65 years of age, make time to talk about Medicare insurance and other health concerns. It could be a life changing discussion.
Source: tnhealthandwellness.com

What is medicare part a b c d

The only reasonable assumption is that one of two things happened: Zimmerman wrongfully tried to detain Martin and Martin resisted, or Zimmerman made Martin fearful and nervous and as a result Martin reemptively struck. How can you have an honest conversation about whether the evidence supports the inference that Zimmerman followed Martin because of the latter’s race when the judge won’t let the prosecutor use the term “racial profiling.” When you are permitted to have juries of only six people how can you expect any diversity and the wider range of viewpoints and perspectives that would presumably come with it? So an innocent young man is killed, and the perpetrator is going to escape punishment for it
Source: blogspot.com

Why the Politics of Obamacare Implementation Could Be Very Different From Medicare Part D

On the other hand, the implementation of Obamacare was designed to feature a mix of winners and losers. Low income people who qualify for Medicaid will be clear winners, yet many other people will see themselves as worse off because of the law. Certain middle income people who buy their own insurance could see big premium increases. Some business owners will be hit with a significant penalty for not providing insurance, while some workers might see their hours cut to avoid this penalty. Parts of the health care industry will also face new taxes.
Source: firedoglake.com

What’s The Difference Between Medicare And Medicaid?

Unlike Medicare, which is available to everyone, Medicaid has strict eligibility requirements. The rules vary by state (beyond the basics set forth in the federal guidelines), but the program is designed to help the poor, so many states require Medicaid recipients to have no more than a few thousand dollars in liquid assets to participate in the program. There are also income restrictions. For a state-by-state breakdown of eligibility requirements see these websites Benefits.gov and BenefitsCheckUp.org.
Source: investopedia.com

Cool Medicare Part A B C D images

Scenario Three: A primary care doctor sees a Medicare patient for an office visit. She thinks her patient has heart failure, starts the initial management. She orders labs and a echocardiogram. The echocardiogram is read by the cardiologist who recommends the patient come and see him. The primary care doctor spent around 15 minutes with patient and gets paid around for the office visit. The patient’s pharmacist later calls and says the medication that was prescribed must be changed due to insurance formulary restrictions. The doctor spends a minute or two reviewing that patients chart before deciding on an alternative medication. The doctor does not receive any additional reimbursement for this service. She was still only paid total. Later, the patient drops off some paperwork for the physician to fill out for the medical insurance. The doctor spends around 10 minutes filling out that paperwork and having his nursing staff fax the complete forms to the insurance company. The doctor does not receive any additional reimbursement for this service. She was still only paid total.
Source: coloradomedicaremedigap.com

Comments Off  :  Add Comment
October 06, 2013

Medicare Advantage: The canary in the coal mine

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



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: 2010 Benefits – Peoples Health Medicare Advantage Plans

Tax Medicare Benefits or require beneficiaries to pay 50% of Part B costs rather than 25%

The chart of taxes paid versus benefits received is based on people retiring in 2030. We are not quite there yet but on average, people get more than they pay for from medicare. There is no doubt that in their present form, both social security and especially medicare are fiscal failures due to their Ponzi like structures and lack of legislative will to make necessary actuarial changes in a timely manner. The fact that the average “Joe citizen “doesn’t understand or take the time to educate themselves on the economics of the system doesn’t help the situation either. This country needs to go back to the drawing board and entirely revamp the tax code and all its loopholes, expenditures and preferences while at the same time getting a grip on entitlements. Anything short of this will just be putting rubber bands and sealing wax on a terribly flawed system. A perfect example of this is fixing a health care system with Obamacare. Do I think any of this might happen in the near future? That’s an unqualified NO, not with the current state of politics but if it doesn’t happen eventually, government shut downs and debt limit fights will seem like a walk in the park.
Source: quinnscommentary.com

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

ObamaCare Clusterfuck: After 55, Medicaid is a loan you pay back from your estate

• 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. The only current exceptions are HCEP and JACC, which are State- funded programs through other State Departments. • The client’s primary residence, while exempt for eligibility purposes, is considered part of the client’s estate, and therefore is subject to recovery. It is also important to reinforce with applicants, clients and families that any interest that the client had in any property at the time of death will be considered part of the decedent’s estate, and therefore subject to recovery. • Annuities are required to be disclosed upon application and recertification for Medicaid. For those annuities which are determined not to be subject to asset liquidation, the State of New Jersey must be named as the remainder beneficiary in the first/primary position for the total amount of medical assistance paid on their behalf. In the case where there is a community spouse and/or a minor or disabled child, the State must be named in the second/secondary position as remainder beneficiary. The State or its eligibility agencies shall require verification of the State being irrevocably named as the remainder beneficiary in the correct position and the State needs to be notified of any contractual changes in the annuities’ income or principal. The remaining benefits of an annuity not subject to liquidation prior to eligibility determination are payable to the State (primary or secondary position) regardless of the age of provided services • “Estate” for Medicaid recovery purposes is now defined by law to include any real or personal property and any assets in which the client had any legal title or interest at the time of death. Included for your reference is a copy of the pertinent regulation. Please note that the definition of “estate” appears at N.J.A.C. 10:49-14.1(e)2 and is quite comprehensive; also note that the term “other arrangements” used in that subsection includes testamentary trusts and annuities. • Please remember that in the process of estate recovery, DMAHS will file a lien against the estate to recover all payments for services received on or after age 55 (except for annuities). • No distribution can be made to heirs or creditors from the estate other than for reasonable funeral expenses, costs associated with the administration of the estate, debts owed to the Office of the Public Guardian for Elderly Adults, and claims with preference under federal or state law (e.g., IRS liens) that may be superior to Medicaid’s (e.g. filed prior in time) without first satisfying the Medicaid program’s lien.
Source: wordpress.com

Should Medicare Benefits Be Taxed?

American Medical Association cancer CBO consumer driven health care diabetes doctors drugs electronic medical records email emergency room EMR ER exercise FDA genetics Health Care Access Health Care Costs health care quality health insurance health IT health policy Health Reform Health Savings Accounts heart disease hospital HSA insurance life expectancy Massachusetts Medicaid Medicare medicare advantage NHS ObamaCare obesity pay for performance public option SCHIP seniors socialized health care Social Security stimulus tax unemployment Uninsured
Source: ncpa.org

Comments Off  :  Add Comment
October 06, 2013

Medicare Hearing Coverage: Hearing Aids, Auditory Implants and Medicare Coverage Policy

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



Section 1862(a)(7) of the Social Security Act states that no payment may be made under part A or part B for any expenses incurred for items or services “where such expenses are for . . . hearing aids or examinations therefore. . . .” This policy is further reiterated at 42 CFR 411.15(d) which specifically states that “hearing aids or examination for the purpose of prescribing, fitting, or changing hearing aids” are excluded from coverage.
Source: medicarebenefits.us

Video: Does Medicare Insurance Cover Hearing Aids? : Medicare Insurance Questions

Senior Health Alert: What To Do About Hearing Loss

Unfortunately, Original Medicare does not pay for hearing exams or hearing aids. In certain cases, Medicare Part B will pay for diagnostic hearing exams, but only when ordered by your doctor. If your hearing problem is due to a specific injury or disease, Medicare will generally cover the charges. Ask your doctor or hearing specialist for more information about the hearing exams that are covered by Medicare, and the specific conditions for a diagnostic hearing exam.
Source: allmedicare.com

Medicare Hearing Aid Bill

The Congress has issued a bill that Medicare would cover the cost of hearing aids, audiologists and such. The title of the bill is Medicare Hearing Enhancement and Auditory Rehabilitation (HEAR) Act of 2009. It is a good thing because the private insurance companies tend to follow the Medicare infrastructure. If Medicare covers hearing aids, then private insurance companies will follow and start covering the hearing aids. So far, there are only 6 House representatives sponsoring this bill and the status is that it has been submitted to Committee on Finance 6 months ago. It will be a long way to get this bill go into motion.
Source: deaflion.com

A Surprising Elder Care Management tip to Consider

Recently, though, we worked together on case involving a 95 year old with a serious cancer. Things became particularly difficult when the doctor and hospital decided that she didn’t need to be in the hospital any longer. The client felt very ill and did not want to leave. Worse, the only available nursing home on short notice was a facility that was not particularly good. Charlotte worked quickly to advise the client (and the client’s agent under a power of attorney), to explain her rights and to advocate for appropriate treatments at the hospital. They kept the client for several more days and stabilized her condition. In the meantime, Charlotte and the agent were able to obtain a space in a great nursing home. The client was very appreciative and so was the agent. My client often expressed appreciation to me for suggesting Charlotte.”
Source: creativecaremanagement.com

Brad DeLong : Will a City in a Region That Accepts Medicaid Expansion Be 5% Larger and Richer in a Decade than One That Does Not?: The View from the Roasterie Part II: Modern Nullification Political Weblogging

The idea is for me to be less self-indulgent and try to drive the conversation. The conversation–even the high-technocratic conversation–spends much-too-much time chasing rabbits flushed by the Pete Peterson Foundation (on the necessity for entitlement cuts), the Wall Street Journal editorial page (on the overwhelming need for low taxes on the rich), the John M. Olin Foundation (on how the New Deal erred in thinking that positive liberty is a thing), and so forth.
Source: typepad.com

Why we don’t wear hearing aids: Our series on the cost of hearing aids

Despite that $2,000-to-$6,000 figure, the cost of hearing aids has actually decreased relatively over time when compared to the rate of inflation, according to an article in Healthy Hearing in April 2010. The article noted the factors that contribute to the high cost: research and development is primary, time spent with the audiologist to fit the hearing aids to the needs of the consumer is also part of the cost. “Averaged over the lifetime of the instruments (three to five years or more), the cost per day of a pair of hearing aids is about three dollars.” Some people would be tempted to point out that that’s cheaper than a latte at Starbucks, but most of us aren’t buying lattes at Starbucks: the daily cost takes a bite out of tight budgets.
Source: clearhealthcosts.com

Newly Proposed Bills Would Affect Medicare Coverage For LTC Facilities

Under a newly proposed bill, Medicare beneficiaries would be eligible for coverage of LTC, ending the existing three day inpatient requirement. Currently, Medicare reimburses LTC facilities only after a patient has spent a minimum of three days as a hospital inpatient.  It is believed that LTC facilities provide many of the same services that have traditionally been available only in hospitals.  The proposed bill requires that a qualified healthcare professional approve the need for skilled care based on a set of pre-authorized requirements. Another bill, the HEAR Act, providing coverage for hearing aids and hearing rehabilitation services for Medicare beneficiaries, was also introduced.
Source: wordpress.com

FAQ: What is Medicare Supplement (Medigap) Insurance?

Medicare Supplement Insurance, also known as Medigap or MedSup coverage, complements Original Medicare (Medicare Part A and Part B) by filling in the coverage gaps of some health care costs that are not covered under those plans. Medigap is an optional program, which means that Medicare does not pay for any part of this coverage. Medigap coverage is purchased through private insurance companies at the cost of the beneficiary.
Source: ehealthmedicare.com

Why Doesn’t Medicare Pay For Hearing Aids Or Eyeglasses?

Hearing aids are elective to, just like glasses. Patients are responsible for 100% of the bill. However Medicare, in certain circumstances, will cover the cost of a prosthetic device. Often though, the cost of prosthetics far outweigh the costs of a hearing aid. This elective also extends to routine hearing tests, which are also the responsibility of the Medicare patient. Regulations vary by the state however, so there may be some exceptions to the contrary. Though most states operate under the same mindset. One exception, though limited, is coverage based on an advantage plan; a secondary premium insurance add on.
Source: seniorcorps.org

Breitenfeldt Group: Offering simple Medicare solutions

Some of the things to consider include premium costs, benefits, provider choice, prescription drugs, pharmacy choice, convenience, travel and quality of care. What will you pay out of pocket? Are extra benefits available, like eye  exams or hearing aids? Does your doctor accept the plan? Do you spend a part of each year in another state? What will your prescription drugs cost? What pharmacy can you use? Do you have or are you eligible for other types of coverage? Do you qualify for extra help? These are some of the questions that will be answered as your Medicare “puzzle” is assembled.
Source: srperspective.com

Comments Off  :  Add Comment
October 06, 2013

Multistate BCBS plan for exchanges announced by Obama administration

Posted by:  :  Category: Medicare

In a statement, BCBSA said: “This builds on our strong working relationship with OPM in the Federal Employees Health Benefits Program, where we provide the most popular plans for federal employees, retirees and their families,” adding, “Blue Cross and Blue Shield companies are working around the clock on health reform implementation.”
Source: medicarebyphone.com

Video: Blue Cross Blue Shield Medicare Supplement-Compare 180 Comp

Georgia BCBS Medicare Supplement

Are you an Insurance Forums member yet ? To sign up for your FREE INSTANT account, please fill out the form below ! Username:     Password:   Confirm Password:     E-Mail:   Confirm E-Mail:          Question of the day:   How many zeros does 100 have? I agree to forum rules 
Source: insurance-forums.net

Does Blue Cross Offer The Best Medicare Supplemental Insurance?

Blue Cross and Blue Shield offers many good health insurance programs. They do not necessarily offer the best Medicare Supplemental Insurance, but they offer low-cost plans that many people can afford easily. The plan that this large insurance conglomerate offers work best for people who are just over the limits necessary for Medicaid but who do not earn enough for the more expensive plans from the large company. The network also provides a large network of health insurance providers. A person with Blue Cross and Blue Shield knows that the insurance that he has will be accepted mostly anywhere.
Source: seniorcorps.org

BlueCross BlueShield of IL Changing Medicare Supplement Rates

BlueCross BlueShield of IL announced a rate increase for most Medicare Supplement/Medigap customers effective March 1, 2013. In addition to the rate increase, changes have been made to the way BlueCross BlueShield of IL sets attained-age premiums. BCBSIL has switched from age bands to different rates for each age. In the past, BCBSIL had the same rate for the same Medigap plan for age groups, like 65-67; now, each age has its own premium rate. The change from age bands to single age rates will cause a few premiums to actually be lower after March 1, 2013 than they are now. For most people though, premiums are increasing.
Source: bcmil.com

Blue Cross Blue Shield Medicare Supplement Plans: Under age 65 « Heath Insurance News

United/AARP will offer plans to those under age 65 as well but only down to age 50. For those on Medicare age 50 to age 64, AARP will offer plan A, B and C.   Plan A has the exact same benefits as the Anthem plan A discussed above.  Plan B covers the same thing as plan A supplement but also will cover the Hospital Part A deductible.  Plan C covers Basic benefits, 20% coinsurance, Part A and B deductibles and skilled nursing facility.  With the extra coverage comes additional cost as plan C with AARP costs over $230.00 a month
Source: croweandassociates.com

Blue Cross Blue Shield of Texas Medicare Supplement Plan

Medicare Supplement Insurance in Texas, like all other traditional forms of coverage does have rate increases and I dislike them as much as you do. BCBS seems to have some of the most stable rates in the industry, where some carriers have pounded the rates some 10 and 12% these guys have not exhibited that type of behavior. They actually experienced a rate decrease this last October which was a pleasant surprise to most seniors. Of course there is no way of knowing what may or may not happen from one year to the next so yes, they could raise rates soon, but so far so good.
Source: medicareinsurancetexas.com

Anthem Medicare Supplement Insurance Quotes in Ohio

In order to qualify, individuals must switch from an existing supplemental policy to a new  Anthem plan with equal or lesser coverage.   This means if you currently own Plans F or J, you can switch to a modernized Plan F (Plan J is no longer for sale as of June 2010) with no health questions asked.   Likewise, you could switch from Plan G to Plan G or Plan N to Plan  N, etc.
Source: ohioinsureplan.com

Newsroom – Insurance Commissioner Ruling on Medigap Rates Clarifies that Blue Cross Blue Shield of Michigan Does Pay Taxes

DETROIT  – Today’s ruling by the Michigan Insurance Commissioner — that Blue Cross Blue Shield of Michigan must discount its premiums on Medicare Supplemental policies by an amount equal to 1% of the company’s total revenue — makes clear that BCBSM is liable for paying a state-imposed annual assessment of about $181.5 million based on 2008 revenue.
Source: bcbsm.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

Comments Off  :  Add Comment
October 06, 2013

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

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



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

Video: Medicare Supplement Insurance Plans – Where Do I Start?

Obamacare and You: If You Have Medicare…

Most of the other changes to Medicare affect how Medicare pays health insurance companies, hospitals and other health care providers for the care received by people on Medicare.  For example, the law reduced what Medicare pays HMOs and other private Medicare Advantage plans.  Other changes are designed to get hospitals, doctors and other health care providers to improve the quality of care they provide for people on Medicare, such as by encouraging providers to work more closely together to coordinate care for patients when they are discharged from the hospital and by taking steps to prevent unnecessary hospital readmissions.  Most of these efforts are in the early stages, and it will take time to see what kind of impact they have.
Source: kff.org

MEDICARE BENEFICIARIES: IT’S THAT TIME OF YEAR TO COMPARE HEALTH PLANS FOR YOUR BEST FIT

AARP Vice President of Health and Family Nicole Duritz, explains “It is important for Medicare beneficiaries to know that during the open enrollment period you don’t have to do anything new. You certainly should not buy any new insurance coverage as a result of the Affordable Care Act. Your Medicare coverage already satisfies the federal requirement that you have health insurance.”
Source: aarp.org

Medicare FAQ: What is Medicare Supplement (Medigap) Insurance

As mentioned previously, Original Medicare, Part A and Part B, provides seniors and eligible disabled and ill Americans with the health coverage they need; however, it does not cover all costs and benefits. That’s where Medicare Supplement Insurance comes in. These plans can fill in the gaps in Original Medicare coverage. Although this type of coverage may not be right for all individuals, it is important to see if you need additional coverage beyond Part A and Part B, and understand your options before enrolling. In this post, we will focus on questions surrounding Medicare Supplement Insurance.
Source: planprescriber.com

Obamacare: Medicare (mostly) not affected

You will not need to go to the health insurance exchange. The plans sold there are not for Medicare members.  They are for people who do not get health insurance through their employer, and for employers with fewer than 50 workers.  Your Medicare supplement plan will not go through the exchanges; it will be the same as you have it now.
Source: bangordailynews.com

CMS wants new study of Lilly's Alzheimer's test before reconsidering Medicare coverage

Amyvid was approved in the United States in April 2012, and is the only such diagnostic test currently available to doctors and patients. But it cannot hope to have appreciable sales unless CMS agrees to reimburse the $3,000 test. Many people begin showing signs of dementia at around 65, the age when Medicare coverage begins.
Source: medcitynews.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

Highlights from AHIP Medicare Conference

Marilyn Tavenner thanked AHIP members for partnering with CMS and for the leadership role they will play in helping consumers get the coverage and help they need through the new health insurance Exchanges.  Tavenner said that she is excited about the open enrollment period that begins on October 1, and she emphasized that the small business owners and consumers she speaks to are eager to learn more about their coverage options.  She also focused on the important role played by the Navigators and the Exchange websites in providing information to the American people.
Source: ahipcoverage.com

How and when to sign up for Medicare

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

Comments Off  :  Add Comment
October 06, 2013

Bigger Deductible Medicare Solution Plan F Duquel Buy It!

Posted by:  :  Category: Medicare

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: Conway v. Paul on Medicare $2,000 Deductible

Medicare Part A deductible to rise by $32 in 2010

The beneficiary pays the deductible when admitted as a hospital inpatient. Medicare Part A pays for skilled nursing facility, inpatient hospital, hospice and certain home healthcare services. Beneficiaries must pay an additional $275 for days 61 through 90 in 2010, and $550 for lifetime reserve days. Only about 1% of Medicare beneficiaries have to pay a premium for Part A services.
Source: mcknights.com

2010 Medicare Part B Monthly Premium Rate, Annual Part B Deductible & Actuarial RatesAnnounced

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here and/or by participating in the SLP Health Care Risk Management & Operations Group on LinkedIn.  To unsubscribe, e-mail here.
Source: wordpress.com

Medical Related Insurance In Dubai

Resveritrol can be noticed in some regularly occurring foods and beverages you probably beforehand eat. Just one of the on the whole common drink information is red bottle of champange. Peanuts additionally red grapes too contain this supplement. A mirrors of red white or red wines and a frosted glass of red watermelon or peanuts some provide about these same amount linked resveratrol. Regarding any resveratrol will likely provide a properly benefit, the degree of resveratrol very are being validated in the testing center are much more than what a person will can find present in food. Fortunately, there are resveratrol antioxidant supplements available that the majority of are made totally from sources like ured wine or Thai knotweed that bring a lot extra resveratrol in persons.
Source: ngosir.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

Comments Off  :  Add Comment
October 06, 2013

Scammer Lebanese Doctor Is Accused of Deaths and Medicare Fraud

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



Not a few foreigners see the United States as a full refrigerator of available riches, populated by gullible sheep who can’t imagine that some immigrants would steal them blind if given the chance. The generous government system of medical benefits is particularly attractive, such that in 2009, Sixty Minutes reported that Medicare fraud was a “$60 billion crime” and south Florida has been quite the hot spot. One symptom: hundreds of Florida Cubans fled to the homeland to escape the FBI.
Source: vdare.com

Video: Company accused of massive Medicare fraud

Feds, local task force target Medicare fraud in Detroit

Medicare fraud continues to make headlines, running the gamut from overbilling for services to a recent local case involving charges of intentionally misdiagnosing patients. Farid Fata, owner of Rochester Hills-based Michigan Hematology Oncology Centers PC and founder of the nonprofit Swan for Life Cancer Foundation, allegedly submitted more than $150 million in billings to Medicare between August 2010 and last month and was paid more than $62 million, according to a formal indictment by a grand jury for health care fraud last week. To fight fraud, the Detroit Medicare Fraud Strike Force is collaborating with the Health Care Fraud Unit at the office of U.S. Attorney Barbara McQuade in Detroit. Crain’s reporter Chad Halcom spoke with McQuade on Friday about those programs. As a business proposition, how is the local health care fraud prosecution team doing in the return on the investment? Presumably the effort pays for itself, but what yield are you seeing above that in terms of judgments or reduced billings? We have both a Medicare Fraud Strike Force that came here from (Washington, D.C.) in late 2009 and health care fraud unit founded (locally) in 2010. We know the task force is not here to stay, but they were so immediately fruitful that we needed to capitalize on that traction and have a program to continue the same efforts long term. Attorney General Eric Holder has said (in a February statement) we have recovered about $7.90 for every $1 spent on these investigations (in the last three years). We don’t have that broken out by local areas, but we have seen some changes in billing (to Medicare) here already. In psychotherapy services, we know that billings were about $3.8 million in the first half of 2011; by the end of the second half of 2012, that was down to $955,000. That’s an area of aggressive enforcement — and the 70 percent change in billing says to me that we’re making some headway. OK, but the local investment is 10 attorneys plus a few support staff, likely a cost of about $1.7 million annually in Detroit. If Eric Holder’s recovery estimate holds true here, doesn’t that mean over $13 million recovered per year? That’s very possible, but it’s extrapolating. There are reasons we think we might have an even more robust return in this area, but we don’t have hard data yet. We do know since the strike force got here, we’ve generated 48 cases with a combined 287 defendants, accounting for billings of $563 million. Of those, 38 have been doctors, which sometimes startles people. And 138 have pleaded guilty, 25 were convicted at trial and the average prison sentence has been about four years, but we’ve seen sentences of as much as 14 years. The Fata case seems particularly onerous, for the reports of chemotherapy allegedly given to patients who didn’t need it or even need other treatment. Is that common? How much fraud comes from legitimate doctors overbilling on real visits and procedures, versus straw patients and drummed-up invoices for treatment that never took place? Most cases fall in the latter category, and as we prioritize our enforcement we go after the most egregious offenders, to recoup the most of our expense. So that often means offenders providing no legitimate services. But sometimes, as in this case, it is a legitimate business billing for more than what’s necessary. And that is also a case where we have one attorney from the strike force and one from our own health care unit working together. Detroit was selected among nine cities for a local strike force in part because software at the Department of Health and Human Services detected outsized billing volume here, for a city its size. It still seems to be a pack leader when new arrests and billing sums are announced from those cities. Are you correcting that anomaly yet? There are probably several factors involved, like size and the local economy and improved enforcement. One reason we’ve been told Detroit was a target market is because we have a larger than average population of people living on medical disability benefits because of the nature of the work done here, and people living in poverty because of the economy who are easily preyed upon by recruiters looking for patient numbers. We have also talked with some social service organizations and they’re aware of that phenomenon of recruiters targeting the poor, and they’re helping us make some headway and alerting us when they see something. People who provide services to the needy don’t like to see them exploited. We do appear to be making a dent in certain markets. Outside psychotherapy, what are some other practices in health care that generate the most investigations and arrests so far? And will the expansion of Medicaid rolls or any other changes under the Patient Protection and Affordable Care Act change that? Home health care is another are with a fair amount of fraudulent activity and really high billings. People who don’t need home health care are being talked into it, or allow recruiters to use them to bill for services not rendered. Prescription drugs are also a target area (of enforcement), because the prescription gives a potential for (Medicare) reimbursement through a so-called patient and then the drug itself can have a street value — particularly in pain medication. But one of the more noncontroversial provisions of the Affordable Care Act is that new provisions that went in effect in 2011 allow for enhanced screening and enrollment requirements to weed out people who can provide billable services, as well as data-sharing across various agencies of government. That could also help us find and correct more of those billing irregularities.
Source: crainsdetroit.com

Medicare fraud outrunning enforcement efforts

The Department of Health and Human Services Office of Inspector General is set to lose a total of 400 staffers that are deployed nationwide as a primary defense against health care fraud and abuse. Though agency officials have yet to decide which investigations will be shelved as staff dwindles, the existing staff is already stretched so thin that the agency has failed to act on 1,200 complaints over the past year alleging wrongdoing — and expects that number to rise. The OIG began shedding staff at the beginning of the year.
Source: publicintegrity.org

Veteran prosecutor describes SoCal as ‘epicenter’ of Medicare fraud

Last week, a federal judge in Los Angeles sentenced the the ringleader of a $9 million Medicare fraud scheme to 18 months in prison, and ordered him to reimburse the federal government. Estill Mitts, 68, was a Vietnam War veteran and recipient of the Purple Heart who apologized for his actions — even as he sought to minimize his role in the operation that including recruiting bogus patients from Skid Row.
Source: scpr.org

A Brooklyn Man Pleads Guilty to Involvement in $13 Million Medicare Fraud Scheme

A Brooklyn resident pleaded guilty to fraud charges in federal court on Friday. Gregory Konoplya, 57, will now face sentencing for his part in an elaborate kickback scheme that funneled $13 million in fraudulent claims from Medicare and Medicaid into a Brooklyn medical clinic.
Source: villagevoice.com

Criminal Defense Consultation

: 85+ pages; 300+ footnotes- Medical records and the hearsay exceptions. If you would like to better understand this intersection of law and medicine, this monograph presents medical record analysis in the context of Evid. R. 803. Also, there is a section which considers the testimonial privilege and medical records. Should you bring a motion in limine to exclude medical records under Evid. R. 803(7)? This monograph will give you the procedural and evidentiary advantages your client needs.
Source: medintelnet.com

FBI — Former Office Manager for Health Care Solutions Network Sentenced in $63 Million Medicare Fraud

Court documents reveal that Palmero was aware that HCSN-FL personnel were fabricating patient medical records. Many of these medical records were created weeks or months after the patients were admitted to HCSN-FL for purported PHP treatment. Palmero was also aware that medical records were fabricated for “ghost patients” who were never admitted to the HCSN-FL PHP. During her employment at HCSN-FL, Palmero actively concealed the fabrication of medical records by preparing, and causing others to prepare, documentation that was later utilized to support false and fraudulent billing to government-sponsored health care benefit programs, including Medicare and Florida Medicaid.
Source: fbi.gov

Comments Off  :  Add Comment