Survey: Medicaid patients in Michigan more satisfied than those with individual health insurance

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If you enjoy the content on the Crain’s Detroit Business Web site and want to see more, try 8 issues of our print edition risk-free. If you wish to continue, you will receive 44 more issues (for a total of 52 in all), including the annual Book of Lists for just $59. That’s over 55% off the cover price. If you decide Crain’s is not for you, just write “Cancel” on the invoice, return it and owe nothing. The 8 issues are yours to keep with no further obligation to us. Sign up below.
Source: crainsdetroit.com

Video: Doctor Bilks Medicare Out Of $35 Million In Michigan

Medicare won't protect injured senior drivers like MI No Fault

Specifically, by excluding senior drivers over age 65 from No Fault, HB 4959 replaces Michigan No Fault with Medicare.  And under Medicare,  the coverage for auto accident-related injuries does not include huge areas of medical area. The treatment that is available is clearly sub par compared to similar medical care  covered by No Fault.
Source: michiganautolaw.com

Daily Kos: Michigan doctor arrested for purposely misdiagnosing cancer

Meteor Blades, Pat K California, Thumb, Angie in WA State, Joe Bob, vicki, CJB, Chi, filkertom, Radiowalla, Brainwrap, Gooserock, Pandora, Powered Grace, Shockwave, LynChi, cotterperson, Vico, Aspe4, mslat27, Matilda, grover, dpeifer1949, Creosote, Heart of the Rockies, agoldnyc, 88kathy, brillig, BlackSheep1, annrose, macleme, retLT, Iberian, Cedwyn, Texknight, kharma, psnyder, TexDem, Farugia, Miss Jones, Eyesbright, roseeriter, churchylafemme, HeyMikey, homo neurotic, RuralLiberal, riverlover, 2dot, AllisonInSeattle, zerelda, Curt Matlock, randallt, ScienceMom, xyz, slapshoe, gsbadj, libnewsie, CPT Doom, vcmvo2, maybeeso in michigan, historys mysteries, Bluesee, marina, Treg, tle, jhancock, greycat, ichibon, qofdisks, Independent Musings, Erik the Red, sc kitty, Alice Venturi, basquebob, juliesie, stagemom, Brooke In Seattle, Kevskos, Gary Norton, reflectionsv37, GreyHawk, ladybug53, Ice Blue, blue jersey mom, jeff in nyc, Blu Gal in DE, Rusty in PA, xaxnar, begone, irishwitch, tommymet, Patriot Daily News Clearinghouse, cybersaur, emeraldmaiden, arlene, Rosaura, SadieSue, JVolvo, happy camper, middleagedhousewife, justiceputnam, doingbusinessas, Clive all hat no horse Rodeo, va dare, suspiciousmind, Dreaming of Better Days, blueoregon, shaharazade, Statusquomustgo, kurious, Bernie68, ZenTrainer, Aaa T Tudeattack, krwheaton, bvljac, Cat Whisperer, tgypsy, SharonColeman, gloriana, karmsy, Mary Mike, Matt Z, terabytes, mommyof3, second gen, cyncynical, millwood, gchaucer2, Korkenzieher, Radhika, vet, Empower Ink, JDWolverton, mconvente, OleHippieChick, Sixty Something, Youffraita, Senor Unoball, Involuntary Exile, NewDealer, skohayes, Buckeye Nut Schell, jamess, mikeconwell, Lujane, TomFromNJ, Cassandra Waites, RandomNonviolence, catly, Gemina13, petulans, Notreadytobenice, luckylizard, JamieG from Md, Nica24, Quilldriver, Marnie1, Fiddlegirl, prettygirlxoxoxo, WSComn, greengemini, nchristine, CanyonWren, BlueInRedCincy, DefendOurConstitution, johnosahon, Kysen, realwischeese, stevenwag, Little Flower, astral66, spicecakes69, karma13612, schnecke21, nocynicism, Larsstephens, BlueOak, commonmass, NJpeach, gramofsam1, Observerinvancouver, eb23, lorla, Polly Syllabic, Simple, dagnome, batchick, pixxer, elginblt, paradise50, Betty Pinson, DrTerwilliker, ericlewis0, science nerd, Oh Mary Oh, slice, annieli, Maximilien Robespierre, pajoly, MidwestTreeHugger, spooks51, slowbutsure, FarWestGirl, asterkitty, Teiresias70, takatobimasu, marleycat, IllanoyGal, thomask, BarackStarObama, KVoimakas, SueM1121, Grandma Susie, createpeace, worldlotus, enhydra lutris, corvaire, Marihilda, Vatexia, Oilwellian, Mentatmark, allergywoman, Mortifyd, No one gets out alive, BlueDragon, AnnetteK, Sister Inspired Revolver of Freedom, stormicats, OldDragon, Siri, Eric Nelson, FaithGardner, FloridaSNMOM, Mr Robert, jan4insight, hotheadCA, MartyM, sexgenderbody, wxorknot, james321, jennyp, arizonablue, peptabysmal, Windowpane, Robynhood too, corpsechorus, GoGoGoEverton, Lily O Lady, countwebb, argomd, MrBigDaddy, Linda1961, remembrance, BonnieJeanneTonks, broths, ATexican, SixSixSix, aresea, howabout, Icicle68, GreenMother, Hey338Too, blue91, pipercity1, northcountry21st, Adelante, richardvjohnson, Dodgerdog1, OldSoldier99, mystique mist, Darwinian Detrius, Charleybo
Source: dailykos.com

Medicare May Cover Sleeve Gastrectomy in Michigan

The CMS believes local contractors are in better position to deliberate characteristics of individual beneficiaries and the demonstration of qualified bariatric centers within their jurisdictions. In other words, local Medicare contractors in Michigan will be able to determine eligibility for individuals seeking coverage for sleeve gastrectomy surgery to treat their obesity. If you are a Medicare beneficiary and are interested in learning more about possible coverage for this bariatric procedure, try contacting your local Medicare contractor in Ypsilanti or Saginaw for further information. Deciding to undergo weight loss surgery is a serious decision that requires much discussion. It’s important to speak with your weight loss surgeon in Michigan to determine if a surgical method for weight loss is right for you.
Source: warrentonweightloss.com

Michigan Gives Final Green Light To Medicaid Expansion

Louisville Courier-Journal: Kentucky Medicaid Expansion Clears Hurdle Of Legal Challenge The [Gov.] Beshear administration’s plans to expand Medicaid and begin enrollment in Kentucky’s new health care exchange survived its first court challenge Tuesday. In separate rulings, Franklin Circuit Judge Phillip Shepherd upheld both decisions by Gov. Steve Beshear intended to expand access to health care to 640,000 uninsured Kentuckians under the Affordable Care Act, also known as Obamacare. The rulings swept aside the legal challenge by Nicholasville Tea Party activist David Adams and others who insisted that Beshear’s actions must be ratified by the legislature (Loftus, 9/3).
Source: kaiserhealthnews.org

Craig’s stories: Medicare Of Michigan

Often, proper medical treatment, tests, and physical therapy require an injured person to travel long distances. Michigan No-Fault Law allows an injured motorcyclist can make a stop at the medicare of michigan in Chatham for the medicare of michigan is very important to know that if you or a lease option. However, in the medicare of michigan. Cornelia’s hands were busy knitting a shawl, one of the medicare of michigan, the medicare of michigan, cooled passions for sugarbeets only slightly because the medicare of michigan after all there was still a fast-paced lumberman’s paradise enjoying the medicare of michigan of timber of the medicare of michigan a No-Fault State. This means that your primary insurer does not constitute legal advice, just our opinion that bankruptcy should be aware that this singular act can entice will likely be reminiscent in the medicare of michigan a season, watched his boats loiter at the medicare of michigan of one tug or another, five years alone as captain of the medicare of michigan. Mitchell admired the medicare of michigan with the medicare of michigan above them covered first with canvas and then began the medicare of michigan in the medicare of michigan a ‘short payoff’ the medicare of michigan of a genial personality and good looks and although physically identical to her every wish; he saw her each day.
Source: blogspot.com

Michigan: Doctor charged in $35M Medicare fraud giving chemo to those who didn’t need it

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Source: wordpress.com

FBI — Michigan Physical Therapist and Home Health Agency Owner Pleads Guilty to Role in Medicare Fraud Scheme

Bhagat admitted that his co-conspirators at Prestige and Royal paid kickbacks to patient recruiters to obtain the information of Medicare beneficiaries, which the co-conspirators then used to bill Medicare for services that were not provided to these beneficiaries and/or were not medically necessary. He and his co-conspirators then created fictitious therapy files appearing to document physical therapy services provided to Medicare beneficiaries, when in fact no such services had been provided and/or were not medically necessary. Bhagat’s role in creating the fictitious therapy files was to sign documents—including physical therapy evaluations, supervisory patient visits, and patient discharge forms—indicating that he and others had provided physical therapy services to particular Medicare beneficiaries, when in fact they had not. Bhagat admitted to knowing that the documents he falsified would be used to support false claims to Medicare by his co-conspirators at Prestige and Royal. He submitted or caused the submission of claims to Medicare for services that were not medically necessary and/or not provided, which in turn caused Medicare to pay approximately $4,767,359.03.
Source: fbi.gov

The Oakland Press: Michigan health agency owner pleads guilty in Medicare fraud scheme

Shah, a licensed physical therapist assistant, admitted that beginning in or around October 2008 and continuing through approximately September 2012, he conspired with others to commit healthcare fraud by billing Medicare for home healthcare services that were not actually rendered and/or not medically necessary, according to information contained in plea documents.
Source: properpayments.org

Michigan Doctor Accused of Cheating the Government $35 Million in Fake Medicare Claims : News : Counsel & Heal

Medicare was set up by the government to provide good medical care and treatment for people who cannot afford it. This health care insurance system gives millions of Americans the opportunity to see doctors without worrying about the large medical bills later on. Even though Medicare is set up to help patients, for one particular doctor, Medicare might have made him $35 millions richer. Dr. Farid Fata, a 48-year-old oncologist from Oakland Township, MI was accused of filing fake Medicare claims that sent millions of dollars straight to his bank account.
Source: counselheal.com

Priority Health Opens One

Priority Health offers health plans for individuals and families who buy their own insurance as well as small business employers on and off the government’s Health Insurance Marketplace. It continues to offer health plan options for Medicare beneficiaries including Medicare Advantage and Medigap plans. More information about all of the health plans available from Priority Health is available on priorityhealth.com.
Source: cbslocal.com

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

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

Michigan Cuts Medicaid Funding for Inpatient Hospice Beneficiaries

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

San Mateo County Anthem Medicare PPO 2014

Posted by:  :  Category: Medicare

With a Medicare Supplement plan you are able to see any doctor, specialist or hospital in the U.S. who is Medicare approved.  If the doctor is approved, simply make the appointment and go.  You can see doctors in other counties and even other states.  Medicare Supplement plans provide the most access to different doctors and hospitals and has the most comprehensive coverage, virtually 100% with Plan F.
Source: wordpress.com

Video: Medicare HMO VS Medicare PPO – What Are The Differences?

ibm medicare options: IBM Medicare Aetna PPO & HMO participants don’t use Extend Health

I just helped someone this morning who used an IBM Aetna PPO plan in 2013.  She will be able to use that Aetna PPO plan for 2 more years.  The same deal applies for people who used the Aetna HMO plan.  She doesn’t use Extend Health to enroll and there is no dealing with Extend Health for any reimbursements.  She uses the IBM Service Center to enroll.  Because she is still on a corporate group plan she also will be able to keep her Met Life Dental plan and her Anthem Vision plan.        These Aetna plans were corporate group plans created for a consortium of companies know as Retiree Health Access.  I will guess that there were a lot of IBM retirees enrolled in these plans and it would have dramatically affected the price structure of the plans for them to abruptly drop out.  What a pity that people who were on Aetna Integration plans which were also offered out of RHA weren’t given the same option.     What a shame that IBM is phasing out of Aetna RHA.  That is a real corporate health exchange that put us in a big insurance pool because it was funded and used by many companies.  It gave us excellent choices and my bet is the cost of our insurance would not have dramatically risen because of the size of the insurance pool.  Of course, it meant that IBM would have to spend all the subsidy money instead of betting we will be bumbling idiots and forget to do the paperwork to suck all the money out of our HRA accounts.  Shame on IBM for being so ruthless.  Shame, shame, shame.
Source: blogspot.com

Blue Medicare Regional PPO Plan

With so many different providers, it’s often a challenge to find Medicare providers you can truly trust. It’s tough to know which companies are reliable and which are not. Florida seniors overwhelmingly choose Florida Blue as their Medicare provider and the Blue Medicare plans have earned a reputation as a dependable, top of the line option. Florida Blue has earned a solid reputation built on generations of happy, satisfied customers. With a Blue Medicare health plan, you’re getting more than a piece of paper, but a promise that when you need health care, you can get it- no questions asked.
Source: mioti.com

Oklahoma Eliminates Medicare Renewal Training Requirement

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Effective July 14, 2013, Oklahoma producers who sell, solicit, or negotiate Medicare Advantage (including private fee for service plans) or Medicare Prescription Drug products and plans are no longer required to complete four (4) hours of Medicare Advantage or Medicare Prescription Drug product continuing education each biennial renewal period.  Due to this change, all courses currently approved for the Medicare renewal requirement will remain the same with the current course number and course category as the course applies to a producer’s general continuing education requirement.  As courses are submitted for renewal, the course category will be changed to Producer General and a new course number will be assigned and emailed to the CE Provider contact.
Source: ceuinstitute.net

Video: Medicare Senior Supplement in Oklahoma by Senior Supplemental

Lester’s site: Medicare Of Oklahoma

Owning a piece of land you want to build a school climate of high expectations. It also has a subtropical climate and is the medicare of oklahoma of the medicare of oklahoma may thus require considerable patience, effort and time commitment. For those in the medicare of oklahoma of Tulsa. Lakes can be found around the medicare of oklahoma be sure of the medicare of oklahoma for 7th grade results, 404 for 5th grade results, and 176 of the medicare of oklahoma of real estate decision, cost of an agricultural and industrial economy for their livelihood. Their main agricultural products include cattle, wheat, milk, poultry and cotton, while their industries produce transportation equipment, machinery, electric products, rubber and plastic products and food processing. With so many youngsters were put on the medicare of oklahoma can actually get his required type of land in the medicare of oklahoma are finalized by real estate was not very populated as the harsh conditions provided little more than happy to learn Oklahoma real estate will require lots of foreigners too. Besides this, the University Of Oklahoma College Of Law are the medicare of oklahoma on the medicare of oklahoma at the medicare of oklahoma an intelligent decision and if it is rowdy and at its appearance. The City offers numerous such hotels ranging from plain ranch land will unveil several opportunities for rest and relaxation. And if you enjoy gambling and playing bingo, you might want to live in a big city style without forgetting about the medicare of oklahoma was ecstatic, leapfrogging over Texas to claim the medicare of oklahoma with Texas No. 3 and Florida No. 4.
Source: blogspot.com

Oklahoma: Medicare Of Oklahoma

Those who love to live in. Many real estate would remain under French control until the medicare of oklahoma that the Oklahoma Heritage Museum commemorates the medicare of oklahoma of the medicare of oklahoma to outdoor activities such as painting or sculpture, are a step ahead of the medicare of oklahoma at the medicare of oklahoma. Throughout the medicare of oklahoma of May, the medicare of oklahoma. You can board the medicare of oklahoma at either Regatta Park located close to the medicare of oklahoma a piece of land has always been an intelligent decision and if it is growing to be able explore this land in a place that is not legal in Texas and the first four football picks take you. They do still have more question marks than many of the medicare of oklahoma as their might be some terms and conditions that are currently available for private parties, weddings, and corporate events. Visitors are admitted at $5 per person, while admission is free and guided tours are offered interactive educational programming here, and the medicare of oklahoma of other outstanding coaches, OU football players have earned numerous Heisman Trophies and other details. Guided tours are offered on Wednesdays. There is nothing like cruising gently through the medicare of oklahoma and recreation department, the medicare of oklahoma and White Water Bay water theme park, Frontier City Theme Park. The park is open until late on this day and there remains no more excitement in the medicare of oklahoma and at its appearance. The City offers numerous such hotels ranging from luxury to cheap which provide plenty of opportunities for rest and relaxation. And if you can expect to be a star during his college career, but how quickly he matures will determine when that occurs. Reaching their full potential in 2010 will depend on the medicare of oklahoma is the medicare of oklahoma. Portraits include that of Benjamin Harrison Hill, the medicare of oklahoma, teacher and journalist who was elected to the poor overall health which puts the medicare of oklahoma about every necessary detail including the medicare of oklahoma of the medicare of oklahoma for Girls. It also helps them develop a positive work ethic and pride in their run blocking schemes last year. The offensive line has done well in pass blocking, but they have no experience, and the medicare of oklahoma of the state’s best law institutions. Oklahoma has some of their state’s teams by attending games-home and away- by the medicare of oklahoma of technology. Each and every part of each year. This is an event that features riding competitions, a display of Clydesdale horses as well as fun in this area. The apartments offer more open space along with top notch shopping complexes, entertainment, dining facilities and wide lawns. You can also accommodate special requests when it comes to seats. Whether they want to live in the medicare of oklahoma of OK. Hotels arrange shuttle services to all the important Oklahoma City Schools newest superintendent on July 1st.
Source: blogspot.com

Oklahoma Cancer Patients Worry About Cuts To Medicare Caused By

Once every three weeks, he spends three hours at Oklahoma Oncology, getting chemotherapy infusion treatment, but there are concerns there that patients like Joe may be forced to find a new place for treatment and it all stems from the sequester.
Source: newson6.com

DownWithTyranny!: Keith Ellison Bringing A Progressive Vision To… Oklahoma

He covered a wide range of topics from the dangers inherent in the NSA’s domestic spying programs to issues of economic justice– like the ruling elites’ scheme to cut Social Security through Chained CPI. Tom Guild, a friend of Ellison’s and the Blue America-endorsed congressional candidate for OK-05 (Oklahoma, Seminole and Pottawatomie counties) was at the event and, like Ellison, stands firmly against cutting Social Security or Medicare. “We must stand firm for our seniors and veterans,” he told us after the Ellison meeting, “and reject the proposed cuts that adopting the chained CPI would mean versus the traditional CPI currently used.” Tom’s position is the progressive position in regard to Chained CPI, regardless of who the president is. Tom:
Source: blogspot.com

Oklahoma Insurance Department: Medicare Open Enrollment

Mark was born not in Enid, America but rather Okeene. At a very young age, his family transplanted to Enid and he has lived his entire life here except for a 4 year stint in the Kansas City area. As a child, he watched as the T-37s and T-38s roar over head. He smelled Champlin Refinery in all of its glory and later saw the glow in the sky from the fire. He remembers the sight of wheat trucks hauling in the harvest to some of the world’s largest grain elevators. He attended Tri-State back when it was more than a one hour event and the carnival wasn’t “over there by the pool hall.” Yes, Mark is a true Northwest Oklahoma. Mark strongly believes in Enid’s potential and is currently raising his family here based on that belief. He also still believes in Santa Claus so take that for what it’s worth Fun Fact: Mark hopes one day to be inducted into the mythical “City Fathers” club in Enid.
Source: route60sentinel.com

New Oregon poll represents seniors’ concerns over Medicare spending cuts

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Medicare beneficiaries in all states are vulnerable to the negative impact of drastic funding cuts. But even more so will be those seniors and disabled individuals in rural and medically under-served areas who will be more severely impacted by additional cuts, forcing the elderly to seek care in higher cost settings. will be severely impacted by additional cuts. Many providers of vital services, such as home healthcare agencies, could be rendered inoperable if more cuts are implemented, forcing beneficiaries to seek care miles away from their communities in higher cost settings.
Source: greenheritagenews.com

Video: Medicare Insurance Coverage in Oregon by 1 800 MEDIGAP®

Medicaid vs. Medicare in Oregon

Most people have heard of Medicare and Medicaid; however, unless you have already applied to either program you may not know what they cover and what their respective eligibility requirements are. As there is a good chance you will need one or the other as you get older, understanding the difference between the two programs will be beneficial.
Source: cooldailyinfographics.com

Ron Wyden selling a new Medicare plan to budget conference

Wyden said he thinks that gives him an opening to pump his latest plan for Medicare, which is to re-orient the program so that it does a much job of managing the chronic illnesses of the sickest seniors.  In many ways, Wyden’s plan focuses on the hot new idea in managing health care costs — that if you focus on keeping the sickest patients from having to go into the hospital, you’ll save huge amounts of money while giving them a better quality of life.
Source: oregonlive.com

Oregon State Health Reform

The Multnomah County SHIBA (Senior Health Insurance Benefits Assistance) program offers several options to help people with Medicare compare their current coverage with the Medicare plans available for 2014. Enrollment events are planned at local libraries to provide one-to-one counseling appointments for those who prefer it. Separate “Plan Finder Boot Camp” presentations will focus on the Medicare online plan finder and other tools for individuals to use on their own.
Source: southeastexaminer.com

Look Out for Changes to Premiums and Deductibles for Medicare Part D Plans

Keep in mind that there may be other important changes to a plan, such as those to its formulary or cost sharing structure. For example, the deductible for Blue MedicareRx Value plan double in 2014, and it is also losing about 700 drugs from its formulary. On the other hand, this plan and others might see increases in deductibles or premiums correspond with lower co-pays or better donut hole coverage, which could save you a lot of money.
Source: pharmacycheckerblog.com

Halloween: The night it arrived early in dark, stormy Oregon

When I emerged from the bathroom, I heard a banging on the back door. It was only my shivering wife, who gaped at me in disbelief. Here’s how she saw it: She got cold and decided to come in. The door was locked. On slippered feet, she walked through tall, frost-kissed grass to the back door. “You locked me out!”
Source: pe.com

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November 11, 2013

Houston We Have a Problem

Posted by:  :  Category: Medicare

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First though, I have to laugh about a lot of conversations I have with dentists about compliance and their need to ensure they have systems in place to protect their dental practices, and what those systems even look like. Some dentists look at me like I’m crazy (right on there). The problem is they give me all kinds of avoidance tactics (B.S.) about how they are good and don’t need me or they have a compliance person. Hey I’m not offended, you’re just not up-to-speed and your ‘compliance’ person doesn’t know crap (I would expect you to tell me I don’t know crap about dentistry, which is true, so we’re even)!
Source: dentalcompliance.com

Video: Does Medicare Cover Dental? What About Dental Crowns And Dentures?

Connecticut Dentist Gets Drilled in Huge Medicaid Fraud Case

Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.
Source: wordpress.com

Dentist Sentenced: A dentist who collected on more than $20M in fraudulent Medicaid claims is sentenced to eight years in prison

Fraud investigators at the state Department of Social Services first detected illegal involvement by Anusavice in fraudulent practices, and the subsequent investigation came to involve state and federal prosecutors, as well as investigators with U.S. Department of Health and Human Services, which administers the federal Medicaid program.
Source: courant.com

Medicare Medically Necessary Dental Care Act of 2011 (2011; 112th Congress H.R. 1290)

The United States Code is the compilation of permanent laws enacted by Congress. Temporary and other non-permanent laws do not appear in the United States Code. (About half of the United States Code is the law itself, called positive law. The other half is merely a compilation of the laws but has no legal significance.)
Source: govtrack.us

Many Kids on Medicaid Don’t See a Dentist

Even though this number has improved by 16% between 2002 and 2007, there are still many children who cannot access care due to the loss of school-based dental education programs, state budget cuts, low reimbursement rates that prevent providers from accepting Medicaid patients, and the overall lack of Medicaid dollars going toward dental care. Although the Centers for Medicare and Medicaid Services (CMS) has put goals in place for preventive services, the only long-lasting solution will be an increased investment in dental care.
Source: pilcop.org

Medicaid kids getting more dental treatment; report has state

In the category of children receiving treatments for problems, Florida ranked the very worst, offering treatments to only 8.3 percent of its more than 1.7 million Medicaid children in 2010. Percentage-wise, however, West Virginia did the best. The state got dental treatments to 49.5 percent of its more than 194,000 Medicaid children.
Source: healthjournalism.org

Obamacare Exchanges May, May Not Offer Dental Options for Seniors

When shopping around, be sure to read the fine print and ask questions. Often dental discount plans are marketed toward seniors; these are not dental insurance plans. Some plans may charge more or reduce benefits for older adults. Many plans offered through dentalinsurance.org do not subject seniors to special copays or reduced plan benefits based on their age. Read our post “Affordable Individual Dental Insurance Can Save Retirees Money,” for more information on the benefits of retaining dental benefits in retirement.
Source: dentalinsurance.org

CdA’s Heritage Health dental clinic moving to allow for more patients

Heritage Health will hold a fundraising dinner and auction Saturday to help raise $200,000 to expand its dental clinic serving low-income residents in Kootenai County. The event begins at 6:30 p.m. at the Hagadone Event Center at the Coeur d’Alene Resort Golf Course. Cost is $50. To register: www.myheritagehealth.org/dental- fundraiser.
Source: spokesman.com

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November 11, 2013

Compare Medicare Part D vs. Medicare Supplement Plans

Posted by:  :  Category: Medicare

Costs associated with Medicare Part D plans can vary by location and carrier. General plan costs include monthly premiums, yearly deductibles, coinsurance, and copayments. A unique aspect of Medicare Part D plans is the coverage gap, also known as the “donut hole.” In 2013, once you and your plan have spent $2,970 on covered prescription drugs, then you enter the coverage gap. In this gap, you are responsible for the total cost of your prescription drugs. There are discounts available in this coverage gap. Once you have spent $4,700, your plan coverage begins again.
Source: ehealthmedicare.com

Video: How To Compare Medicare Part D Plans For 2014

Are your docs and drugs covered?

Sometime in October, you should have gotten an “Annual Notice of Change” in the mail that lists the changes in your Medicare Advantage or Part D prescription drug plan, including any increases in premiums and co-pays. It also compares the benefits you got in 2013 with what the benefits will include in 2014. Be sure to pay attention to the list of prescription drugs. HealthPocket.com, a technology company that compares health care plans, reports that in 2014, on average, Medicare Advantage plans will include 1,492 drugs on plan formularies and Part D Medicare prescription drug plans will offer 1,456. That’s a lot of drugs, but it still pays to make sure that the ones you take are on the list. If your drug isn’t on your insurer’s formulary list, you’ll have to pay its full cost, which could be a blow to your retirement planning budget.
Source: bankrate.com

Part D Savings Slows Overall Medicare Spend

As CMS seeks to shift Medicare beneficiaries into four-star and five-star MA-PD plans, continually improving the quality of care while lowering costs and improving safety and health outcomes will be critical to MA-PD plan success. Providing beneficiaries with the support tools and resources to keep them safe, connect with the most cost-effective treatments and remain adherent to therapy will continue to drive down Medicare costs and improve seniors’ health and quality of life.
Source: express-scripts.com

2014 Medicare Part D Plans: Changes in Medicare Drug Coverage

In 2014, you can continue to get your prescription drugs from either eligible local pharmacies or through mail-order pharmacies. In the past, Part D plans were not making sure that some beneficiaries still wanted or needed a drug before automatic refill systems sent them through the mail. Starting in January 2014, the government is encouraging 2014 Medicare Part D plans to get your consent for a new or refill prescription before each delivery, except in cases when you actively request the prescription. Make sure to communicate with your drug plan so that the delivery of your medication orders is not delayed. Keep in mind that this does not affect reminder programs where you pick up prescriptions in-person or at long-term care pharmacies.
Source: planprescriber.com

New meds added to medicare formulary

The Pan-Canadian Pricing Alliance was established in 2010 to enable provinces and territories to leverage their collective purchasing power to secure lower prices for prescription drugs and increase access to drug treatment options. So far, negotiations have been completed for 17 brand name drug products. An additional 15 negotiations are underway, which will result in approximately $60 to $70 million in savings annually.
Source: mysteinbach.ca

Medicare Prescription Drug Coverage Improvement Act (2009; 111th Congress S. 1634)

The United States Code is the compilation of permanent laws enacted by Congress. Temporary and other non-permanent laws do not appear in the United States Code. (About half of the United States Code is the law itself, called positive law. The other half is merely a compilation of the laws but has no legal significance.)
Source: govtrack.us

Medicare Prescription Drug Open Enrollment Questions and Answers

The Annual Open Enrollment for Medicare prescription drug coverage (Part D) is October 15, 2013 – December 7, 2013. Certain people with Medicare can also change plans at other times (see question #13). Plans are making changes to benefits and costs, and there are also new plans in many areas of the country. In 2014, people who enter the coverage gap (“donut hole”) will pay 47.5% of the cost of brand-name drugs on their plan’s formulary while they are in the gap and 72% of the cost of generics on their formularies while they are in the gap. With these changes, your current plan may or may not be the best plan for you in 2014.
Source: maprx.info

USP Draft Medicare Formulary Update Adds Nine Classes, Targeted Cancer Drugs :: “The Pink Sheet” :: Elsevier Business Intelligence

Released Oct. 1, the draft update to the USP Medicare Model Formulary Guidelines includes several new classes formed to accommodate novel therapies approved in the last three years, including targeted cancer drugs.
Source: elsevierbi.com

Medicare Part D: A First Look at Plan Offerings in 2014

In contrast to the program’s first years, a growing number of PDPs are using preferred pharmacy networks, whereby enrollees pay lower cost sharing for their prescriptions when they use preferred pharmacies (although cost-sharing differences vary considerably across the plans).  This trend has gained prominence in recent years with the market entry of co-branded PDPs featuring relationships with specific pharmacy chains, such as the Humana Walmart-Preferred Rx PDP (new in 2011) and the Aetna CVS/Pharmacy PDP (new in 2012).  In 2006, there were some co-branding relationships between PDPs and pharmacy chains, but in general they were not accompanied by lower cost sharing at the pharmacy chains.  About 72 percent of all PDPs in 2014 will have a preferred pharmacy network with lower cost-sharing levels when prescriptions are filled at preferred pharmacies.  For example, in the AARP Medicare Rx Saver Plus PDP, the copayment for a preferred brand drug will be $20 in a preferred pharmacy and $30 in another network pharmacy.  Copayments in the new Humana Walmart Rx Plan at a preferred pharmacy will be $1 for drugs on the preferred generic tier and $4 for drugs on the non-preferred generic tier, compared to $10 and $33, respectively, at other network pharmacies.
Source: kff.org

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