Compare Medicare Part D vs. Medicare Supplement Plans

Posted by:  :  Category: Medicare

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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: Medicare Supplement Plans (Medigap Coverage) Overview

Perfected Medicare Supplement Coverage

This kind of Medigap Texas insurance protection policies are classed as based on some types of salary they conserve your company. You should either obtain easily affordable rates in improvement to high deductibles or high monthly premiums along with less expensive deductibles. Yourself have to are nevertheless the one toward determine which range of plan your business would like that would go with. Either manner that you will obtain certain sort of a solution. It recently depends on just how probable you will also be in should have of having which will pay your tax deductible. If you are for your current most part certain ready to now have to carry available this, obtain a new good inexpensive deductible or perhaps even else put a new funds away ahead of time. That way buyers are equipped whether or not something transpires.
Source: afterbcsurgery.org

What is Medicare Supplemental Insurance?

Medicare is a type of insurance that is regulated by the government. It is available in four parts. Part A is hospitalization coverage, while Part B is standard medical insurance. Part C combines the first two and is available through one of the private insurance companies approved by the Medicare board. Medicare Part D is coverage for prescriptions. There are some things that these parts of the insurance do not cover, which is where Medicare supplemental insurance fits in. in order to understand this addition, you must have a little knowledge of the other parts of the Medicare.
Source: didntbuildthat.com

Medigap Trial Right and Guarantee Issue Right Protections

By pressing “Click Here And Get Your Quote ” above, (1) I consent to receive phone calls from TZ Insurance Solutions LLC or its affiliates, or one of its third-party partners, or their service provider partners on their behalf, regarding their products and services, at the phone number provided above, including my wireless number, if provided, and (2) I agree to this website’s privacy policy and terms and conditions. I understand that these calls may be generated using an automated technology. Partners may include SelectQuote, Allied Insurance, United Medicare, Insphere, eHealth and Coventry. You are not required to grant consent as a condition of purchasing any property, goods or services.
Source: medicaresupplement.com

An Introduction To The Medicare Supplemental Plan F at Jonathan Mods Central

In order to get a good understanding of Medigap Plan F, you need to examine the basic benefits covered as well as some additional benefits that participants are eligible for. To begin with, basic benefits include hospitalization through Part A, twenty percent of Medicare approved medical expenses through Part B and also the initial three pints blood every year as well as hospice care through Part A. The additional benefits beyond the basic Medicare benefits through Plan F also cover skilled nursing facility care, Part A as well as Part B care deductibles and Part B excess charges. It also offers coverage for individuals traveling abroad who end up needing emergency care.
Source: modscentral.com

Medicare: Original, Replacement, Supplemental and Extra Crispy

Medicare Part B also covers outpatient hospital services including Emergency Room Visits and Hospital Observation. Generally, this means the patient pays a copayment for each individual outpatient hospital service. This amount may vary by service. The copayment for a single outpatient hospital service can’t be more than the inpatient hospital deductible. However, the total copayment for all outpatient services may be more than the inpatient hospital deductible. Part B also covers most of the doctor services when you’re a hospital outpatient. The patient pays 20% of the Medicare-approved amount after they pay the Part B deductible. Generally, the prescription and over-the-counter drugs received in an outpatient setting (like an emergency department), sometimes called “self-administered drugs,” aren’t covered by Part B. Also, for safety reasons, many hospitals have policies that don’t allow patients to bring prescription or other drugs from home. If the patient has Medicare prescription drug coverage (Part D), these drugs may be covered under certain circumstances. The patient likely will need to pay out-of-pocket for these drugs and submit a claim to their drug plan for a refund.
Source: managemypractice.com

GAO Ties Medicare Supplemental Coverage to Higher Health Spending : Health Industry Washington Watch

At the request of Senate Republican policymakers seeking a better understanding regarding the impact of supplemental coverage on overall Medicare spending, the Government Accountability Office (GAO) recently compared the health care expenditures of beneficiaries with only traditional fee-for-service (FFS) Medicare coverage to those of beneficiaries who have supplemental coverage from either private insurance companies (a.k.a., Medigap) or employer-sponsored plans. Based on a review of 2010 data, the GAO concluded that health care expenditures are higher for beneficiaries with supplemental coverage than for beneficiaries with FFS Medicare only. More specifically, both average Medicare spending and out-of-pocket expenses for beneficiaries with Medigap were significantly greater than for those with Medicare FFS coverage only. Within the FFS only group, those who are enrolled in Medicare’s Part D prescription drug program spent considerably more on health care than those who are not enrolled in Part D.
Source: healthindustrywashingtonwatch.com

Does Medicare Supplemental Insurance Suit Your Needs?

Those aged 65 and older can rely on traditional Medicare Parts A and B to pay for a broad array of healthcare services and supplies, though by no means will everything be covered. For this reason, it may be wise for such individuals to purchase a supplemental insurance policy to pick up the slack. This type of policy, also referred to as Medigap coverage, is sold by private carriers and is intended to take care of payment for things that traditional Medicare does not include. Such expenses include co-pays, annual deductibles and coinsurance. Certain available Medigap policies also provide coverage for services that have no coverage whatsoever under traditional, original Medicare.
Source: kurafire.net

Medicare and Health Insurance, What is Covered, Medicare Supplement

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

NY Identifies $496 Million in Home Health Medicaid Error Payments

Posted by:  :  Category: Medicare

AAHomecare AARP Addus HomeCare Corp. Almost Family Almost Family Inc. Amedisys Amedisys Inc. American Association for Homecare 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

Video: End circumcision under the New York State Medicaid program.

Survey: N.Y. Doctors Adamantly Oppose ObamaCare

There are compelling reasons for patients to opt out of Obamacare, Medicaid, and even Medicare. The most important reason is poor access to high quality physicians. Few of these currently accept Medicaid patients, and more each day are declining to accept new Medicare patients. A large element of the Obamacare strategy is to expand Medicaid to families with incomes well above the poverty line. A silver lining in the otherwise horrendous Roberts court decision upholding Obamacare is the ability of states to refuse to expand Medicaid, and a large number have taken advantage of this.
Source: thenewamerican.com

Fix the Handful of U.S. Hospitals Responsible for Out

When we applied the techniques of Six Sigma analysis to the CMS data, we found that just 32 hospitals — less than 1% of the hospitals in the data — accounted for about 25% of the excess accepted charges. (Hospitals determine what they will charge, or bill, for items and services, and CMS then decides how much of that amount is appropriate and will be paid.) A handful of hospitals in New York State accounted for nearly half of them. Add some hospitals in Baltimore, Maryland, and some in the cities of San Francisco, Stanford (Palo Alto), and Los Angeles in California, and the figure goes to nearly 80%. If the excess is that highly concentrated, it is likely that significant efficiency gains can be achieved with relatively little effort.
Source: hbr.org

6 Reasons to Choose a New Medicare Part D Plan for 2014

Posted by:  :  Category: Medicare

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By Emily Brandon Retirees have the option to switch Medicare Part D prescription drug plans between now and Dec. 7. Most seniors who stick with their current plan in 2014 can expect to pay higher premiums and other out-of-pocket costs than they did in 2013. Only 13 percent of participants picked a new prescription drug plan voluntarily during this annual enrollment period between 2006 and 2010, according to a Kaiser Family Foundation analysis of Centers for Medicare and Medicaid Services data, but many of these retirees were able to significantly decrease their premium costs. Here’s why you should consider picking a new Medicare Part D Plan for 2014. Medication changes. Your medication needs could change throughout your retirement. If you are now using new medications or think you might in the coming year, you should consider evaluating which plan will cover you best going forward. Plans can and do change which medications they will cover each year and how much participants are charged for each medication. Just because your medications were covered with a given copay in 2013 doesn’t mean they will continue to be covered at the same level or at all in 2014. “Because plans can change pretty much every feature of the benefit design, including the list of drugs that they cover, people might want to switch out of a plan if, for example, the plan stops covering a drug that they are taking,” says Juliette Cubanski, a policy analyst at the Kaiser Family Foundation. “It might cost them a lot of money if they had to pay for it out of pocket outside of Part D.” Find lower premiums. The average premium is expected to increase by 5 percent from $38.14 in 2013 to $39.90 in 2014 if retirees stay in their current Part D plan, according to a recent Kaiser Family Foundation analysis of 2014 plan offerings. Many beneficiaries (44 percent) will pay between $1 and $10 more if they remain in their current plan in 2014, and 14 percent will experience a monthly increase of more than $10. Premiums will increase by more than 50 percent next year in United HealthCare’s AARP Medicare Rx Saver Plus and First Health Value Plus. Retirees enrolled in the First Health Essentials and the Humana Preferred Rx Plan will also face double-digit premium increases unless they switch plans. Avoiding high premiums is the most common reason retirees select new prescription drug plans. Nearly half (46 percent) of enrollees who switched plans paid at least 5 percent less in premium costs the following year, compared to 8 percent of those who did not switch plans, KFF found. More than a quarter (28 percent) of beneficiaries facing a monthly premium increase of $20 or more switched prescription drug plans during the annual enrollment period, versus 7 percent of those facing a more modest premium increase of up to $10 or no change in their premium. “Some plans do increase their premiums quite considerably from one year to the next,” Cubanski says. “When faced with that kind of sticker shock, that can motive people to go and look at what other plans are available that the person might think is more affordable.” Seek lower copays and other cost sharing. Besides premiums, Medicare Part D beneficiaries face a variety of other out-of-pocket expenses, including deductibles, copayments, coinsurance and costs in the coverage gap. When both premiums and cost sharing for drugs are considered, 44 percent of retirees who switched plans had overall costs that were at least 5 percent lower than the previous year. Only 28 percent of seniors who didn’t switch plans saw their out-of-pocket costs decline by at least 5 percent. “If the particular drugs you use are on more expensive tiers or not on the formulary, that can lead to higher out-of-pocket costs,” says Jack Hoadley, a health policy analyst at Georgetown University. “Go on the online plan finder on Medicare.gov and use your current mix of drugs to calculate your total out-of-pocket costs and not just the premiums.” Reduce your deductible. Just over half of prescription drug plans will charge a deductible in 2014, and most charge the maximum possible amount of $310 before any drug costs will be covered. The share of plans with a smaller deductible has declined from 24 percent in 2010 to just 4 percent in 2014. However, 47 percent of plans will charge no deductible in 2014, meaning retirees will get coverage on their first prescription, often in exchange for a higher monthly premium.
Source: dailyfinance.com

Video: Kaiser Permanente Medicare Navigation Video

Ask The Experts: Retirement

Q. I retired from government almost eight years ago. I have had Kaiser health insurance all this time. I am about to turn 65. I have to do something with Medicare sign-up, so I spent time with my health plan provider (Kaiser Perm) the other day and the person we talked to wasn’t sure my wife would continue on my plan should I go with them for part B or their Senior Advantage plan. I told the rep I was sure she would, but the Kaiser rep said I needed to check with the government. My wife is five years younger than me. If I go with Kaiser for part A and B, will my wife be carried on the plan, too?
Source: federaltimes.com

MRA Alerts and Updates: Kaiser Permanente’s Medicare Plans Are No. 1 Again

“Our high ratings recognize Kaiser Permanente’s superb physicians and care providers,” said Amy Compton-Phillips, MD, associate executive director for Quality at The Permanente Federation, the national umbrella organization of more than 17,000 physicians who provide care to Kaiser Permanente’s more than 9.1 million members. “This recognition, however, is not merely about rankings. These scores demonstrate that at Kaiser Permanente improving the health of our members is our calling. We continuously strive to improve and provide better care to the more than 9.1 million Kaiser Permanente members we serve.”
Source: blogspot.com

Medicare Advantage Fact Sheet

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

Kaiser Permanente's Top

/PRNewswire/ — Kaiser Permanente’s highly rated Medicare health plan website, kp.org/medicare, has launched a new feature that is designed to help seniors find information more easily and conveniently. Medicare beneficiaries can search online for Kaiser Permanente Medicare seminars in their area using their own criteria, and they can register online for a seminar of their choice. Through this new RSVP Web capability, those who provide their email address will receive an email reminder with location information and a phone number to call for more details.
Source: virtual-strategy.com

Kaiser Permanente Colorado Rated Number One in Nation for Prevention and Health Promotion : North Denver Tribune

Kaiser Permanente’s integrated approach to care delivery, innovative Web-based tools and robust system of electronic medical records enables better care coordination for physicians, improved clinical outcomes for patients and a higher quality of care for all. Just last month, Kaiser Permanente was recognized by the National Committee for Quality Assurance as the highest-rated commercial health insurance plan in Colorado and No. 13 in the nation. New for this year, Kaiser Permanente also received the “Best Value” recognition in Colorado for Diabetes Care factors for both Private plans (commercial) and Medicare. In addition, “NCQA’s Health Insurance Plan Rankings 2013-2014″ lists Kaiser Permanente as the top Medicare plan in Colorado and No. 4 in the nation. This is the fifth year in a row Kaiser Permanente Colorado has been among the top five Medicare plans in the U.S.*
Source: northdenvertribune.com

State Highlights: Calif. Hospital Chain Settles Anesthesia Billing Suit

Posted by:  :  Category: Medicare

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California Healthline: Campaign Advocates Health Coverage For Undocumented Immigrants In California The California Endowment has launched a statewide campaign to shine a light on the estimated one million Californians who aren’t eligible for coverage under the Affordable Care Act because they don’t have the right paperwork. Television ads, billboards and other advertising showcase undocumented immigrants in California who are not eligible to buy insurance through the ACA’s health exchanges. The California Endowment has identified a handful of Californians — mostly young professionals and students — to illustrate the situation. The crusade, not tied to any specific legislation or ballot measure nationally or in California, has wide-ranging goals (Lauer, 11/4).
Source: kaiserhealthnews.org

Video: Kiwi Medicare Billing Feature

How to Work from Home Doing Medical Billing and Coding Jobs Online

The medical billing profession is open to anyone with a high school diploma or an equivalent GED certificate. This qualifies you to enroll for a medical billing course. Most medical billing courses are independent of standard degree programs at local colleges and can be completed in the classroom or online. The medium of learning notwithstanding, it is important you choose a medical billing course offered by an accredited organization that has been training medical billers for several years. If you have not yet graduated from high school, courses like computers, accounting, math, speech, and business would make a solid foundation for your future career.
Source: mytopbusinessideas.com

Doctor Blows Whistle; Hospital Liable to the Tune of $240 Million

Tuomey’s misconduct began after 19 physicians suggested they were considering shifting their outpatient procedures to a competing hospital. In response, the 242-bed South Carolina hospital offered the physicians 10-year compensation agreements conditioned on their performing all of their outpatient procedures at Tuomey. Eighteen of them took the deal. The nineteenth filed a whistleblower action against Tuomey contending that the compensation exceeded the market value of the physicians’ services and that Tuomey intended it to disguise illegal referral fees. The jury agreed. Under the False Claims Act, Tuomey is liable for treble damages, which, with penalties and fines, puts it on the hook for $240 million.
Source: wecomply.com

Scrutinize Medicare, Medicaid Billing Before Uncle Sam Does

Staying off federal investigators’ radar for Medicare and Medicaid billing is all part of maintaining sound billing practices for any medical office. Keeping accurate and complete medical records for services provided and completed diagnoses already should be part of your day-to-day business. But every insurance claim – for Medicare or any other private-sector provider – should be properly supported by documentation. The federal government may review a patient’s medical records to verify a claim, and will typically take the position, “If you didn’t document it, you didn’t do it.”
Source: dmagazine.com

Publish Of Medicare CodesAvila College

Medical billing and programming are two exclusively different areas of knowledge. People can could be choose to bring a certification back in either of often the fields or could very well get trained here in both areas and as well , in this condition they are credited as medicare part f companies. The best thing when it comes to this training prepare is that this particular enables people appear for a work in diverse aspects such as hospitals, private clinics, prepare companies, assisted dining centers, rehabilitation shelving units and hospitals also as home good health services. Factors numerous Staten Destination medical billing while coding training cosmetic centers that even render a provision as for on job training, especially if and they are already currently employed in a complimenting field.
Source: avilacollege.org

Medicare Billing Certificate Programs for Part A and Part B Providers

Learn about the Medicare Program and the specifics for your provider type with a special focus on Medicare billing, and receive a certificate in Medicare billing from CMS for successful completion of the program. Successful completion consists of completion of all required web-based training courses, required readings, and a 75-percent or higher score on the post-assessment. To participate in either the Part A or Part B provider type program, visit
Source: wordpress.com

Medicare Insurance Enrollment Periods

Health related billing and development are two exhaustively different areas of expert knowledge. People can potentially choose to experience a certification back in either of typically the fields or might get trained throughout both areas not to mention in this scenario they are credited as medicare part f authorities. The best thing exactly about this training procedure is that this particular enables people to be able to for a do the job in diverse merchants such as hospitals, private clinics, insurance cover plan companies, assisted dining centers, rehabilitation zones and hospitals also as home well-being services. You can apply numerous Staten Destination medical billing and additionally coding training centres that even render a provision as for on job training, especially if and they are already working in a interrelated field.
Source: ncow.org

More from CMS on FQHC Medicare Billing

Federally Qualified Health Centers (FQHC)  FQHCs (77X TOB) claims with dates of service on and after Sat Jan 1, 2011, containing HCPCS codes G0402, G0389, G0436, G0437, Q0091, G0101, G0130, 77078, 77079, 77080, 77081, 77083, and 76977 are being processed and paid incorrectly due to coinsurance being incorrectly applied. Medicare contractors have been instructed to hold claims impacted by this problem until a correction is implemented. A software correction is scheduled for June 2011.
Source: nachc.com

Medicare billing training

advantage Benefit coinsurance com Complement cost cowl firm health information insurance medical health insurance medical insurance plan Medicare medicare beneficiaries medicare benefit medicare drug plan medicare insurance medicare part c medicare part d medicare plan medicare protection medicare supplement medicare supplemental insurance medicare supplement insurance medicare supplement plan medicare supplements Medigap medigap plans number person personal insurance coverage plan premium prescription prescription drug coverage Protection provider Safety sixty Social state supplement supplemental medicare insurance website
Source: fluxfeatures.com

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November 18, 2013

Aetna, ConnectiCare Push Collaborations With Health Providers In Private Medicare Plans

Posted by:  :  Category: Medicare

Treatment of some Medicare patients presents unique challenges, the insurers say. Patients who require more than basic care often have several doctors or other points of contact in the medical care system, which means coordinating treatments can be more difficult. For instance: ConnectiCare said a typical Medicare patient sees more than seven doctors in a year and uses nine different medications, so a key piece of its pilot program will be identifying high-risk patients and providing data to help coordinate their care.
Source: courant.com

Video: ConnectiCare Medicare Advantage Agent Training Part 2

Connecticare Sets The Stage For Fun In 2010

PRLog (Press Release) – May 25, 2010 – Inspired by timeless adages such as “Laughter is the Best Medicine” and “An Active Mind is a Healthy Mind,” ConnectiCare has created the 2010 “Setting the Stage” program for its VIP Medicare members. The program will provide free admission to events such as trivia game shows, dance classes, museums, movies, comedy shows and more to give members incentive to stay active and healthy. “Our ‘Setting the Stage’ program will provide free admission to a number of fun events around the state for our VIP Medicare members. It’s a great way to help keep our members feeling vital, fit and always smiling,,” says Tony Tedeschi, Director of Medicare Program Management with ConnectiCare. “Additionally, we are hosting four trivia competitions at locations around the state to see who knows the most about the 1950s through the 1980s. The top three contestants will advance to a final challenge in September in Cromwell hosted by Scot Haney of WFSB TV 3 and Better Connecticut, where the top finisher will be crowned the ‘Know it by Heart’ trivia king or queen. It should be lots of fun and an event-filled summer for all of our members.” Details about all of the ConnectiCare VIP Member exclusive events can be found on ConnectiCare’
Source: prlog.org

Choose the Right Medicare Supplement or Medicare Advantage Plan « Heath Insurance News

Medicare Supplement Plans-Medicare Supplement plans are secondary plans that can be purchased from a private insurance company to help cover the gaps in Medicare part A and B. The plan options are standardized in CT with plans A-L. (M and N will be added in June 2010). Plans A-L provide different levels of coverage depending on which plan you choose. The plan benefits can not change so any company that offers a plan must offer the exact same benefits. For Example Plan J with Anthem BCBS is exactly the same as Plan J with AARP (United HealthCare). The only difference is in the rate that the private company charges for them and the rate can vary greatly. One company in CT charges $184.00 a month for plan J while another charges over $300.00 a month for the exact same plan.
Source: croweandassociates.com

Medicare Advantage Plans Connecticut « Heath Insurance News

Aetna- Currently offer plans in Fairfield, Hartford, Litchfield and New Haven county. They have a $0 premium plan HMO, $94.00 HMO and a $90 PPO plan. The $0 premium plan has benefits second only to Wellcare when compared to the other $0 premium plans in the state. They also have a substantial network to go with the plan and allow for access to any Aetna Medicare HMO provider nation wide. The Aetna PPO is not competitive at this point due to a $1,000 out of network deductible.
Source: croweandassociates.com

St. Francis Hospital, Connecticare sign collaborative care pact

St. Francis Hospital’s Connecticut Joint Replacement Institute and Farmington health insurer Connecticare are forming a new collaborative effort aimed at better coordinating treatment for total hip and knee replacement surgeries.
Source: hartfordbusiness.com

HealthSpring, Cigna Use Both Names To Market Medicare Plans

The television campaign is within the company’s existing marketing budget, said HealthSpring spokeswoman Graham Harrison. Cigna and HealthSpring researched each company’s brand to determine how to best market Medicare products in the future. The campaign is meant to build on Cigna’s strength as a known health service company and HealthSpring’s expertise in Medicare.
Source: courantblogs.com

Connecticare Health Insurance List Of Health Insurance Companies

googletag.cmd.push(function()googletag.display(‘div-article-top’);); Collision and Comprehensive insurance are optional automobile insurance coverages. If you still have a lien against your vehicle, the agreement you have with your lender will force you to carry these coverage types. If you have paid off your car, you can decide to keep or drop these aspects of your policy. You can cut your auto insurance premiums if you remove or lower these parts of your insurance policy’s protection. Collision insurance can pay for the cost to replace your automobile when your insured auto hits or is hit by another car. It can also pay for the cost to repair your car when a covered automobile hits a something other than a automobile such as a Jersey barrier. Comprehensive insurance is also known as “Other than Collision.” This type of coverage pays for damages caused by flood, vandalism, contact with birds or animals, etc. Since both collision insurance and comprehensive insurance compensate you for damage to your car and not someone else’s, you are allowed to decide whether or not to drop these from your policy. However, if your vehicle is leased, or you have a lien on your vehicle, you probably will not be able to do so because the actual owner of the vehicle or the lender will want their interests protected. The liability portion of your automobile insurance policy is the primary aspect of the policy that pays others for their damages. If you collide with another auto and you don’t have collision insurance, that fact will not impact the amount of money the other party might get. Why Should You Eliminate Collision Insurance? The costs for this aspect of your auto insurance coverage may be more than you want to pay. If your auto is totaled, the insurance company will only pay you its book value. At some point, you may feel that the potential return has been reduced enough that the cost of the collision insurance is no longer justified by the potential payment you might get from your insurance company. If you own your automobile free and clear you can contact your insurer and drop or reduce the coverage. You can reduce your collision coverage by raising the deductible. This will slash therates and still give you some protection. Your lien holder or leaser may allow you to raise the deductible up to a specified limit. Why Should You Drop Comprehensive Insurance? The logic behind removing or reducing automobile comprehensive insurance is the same as the thinking associated with cutting collision insurance. However, since the cost for comprehensive insurance is less than the cost of collision insurance, you may want to keep it even after you have dropped your collision coverage. If your automobile is leased or you have a lien on it, you may not be able to drop the coverage. However the leaser or bank or lender may allow you to reduce the coverage by raising your deductible. This will reduce your Costs, although not as much as completely cutting the coverage would. Most cars lose value as they get older. This reduces the amount of money that an insurance company is likely to pay to repair or replace a car. At some point you may feel that the amount of premium your auto’s collision or comprehensive coverage adds to your auto insurance bill is too much. Exactly when that point comes is determined by your personal comfort level with risk. Dropping comprehensive insurance coverage and/or collision coverage means that you take more risk. If your feel that you are unlikely to have an at fault accident since you drive safely you may feel that you can take this risk. If you garage your automobile your vehicle is perhaps less likely to be stolen or vandalized. If this is the case, you may want to drop the coverage.
Source: averagecostofhealthinsurancediscounts.com

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November 18, 2013

An Introduction To The Medicare Supplemental Plan F at Jonathan Mods Central

Posted by:  :  Category: Medicare

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In order to get a good understanding of Medigap Plan F, you need to examine the basic benefits covered as well as some additional benefits that participants are eligible for. To begin with, basic benefits include hospitalization through Part A, twenty percent of Medicare approved medical expenses through Part B and also the initial three pints blood every year as well as hospice care through Part A. The additional benefits beyond the basic Medicare benefits through Plan F also cover skilled nursing facility care, Part A as well as Part B care deductibles and Part B excess charges. It also offers coverage for individuals traveling abroad who end up needing emergency care.
Source: modscentral.com

Video: Medicare Supplements – 5 Things To Know Before You Buy A Medicare Supplemental Policy

What is Medicare Supplemental Insurance?

Medicare is a type of insurance that is regulated by the government. It is available in four parts. Part A is hospitalization coverage, while Part B is standard medical insurance. Part C combines the first two and is available through one of the private insurance companies approved by the Medicare board. Medicare Part D is coverage for prescriptions. There are some things that these parts of the insurance do not cover, which is where Medicare supplemental insurance fits in. in order to understand this addition, you must have a little knowledge of the other parts of the Medicare.
Source: didntbuildthat.com

Is Getting Supplemental Medicare Insurance A Good Idea?

Medigap policies work with Medicare Parts A and B by supplementing the existing benefits. Medicare takes care of all payments first, and whatever is left over is either taken care of by your Medigap policy or you need to pay it out of your own pocket. Consider the costs of additional medical services needed as you grow older, and it makes sense to buy a Medigap policy.
Source: micheleandreabowen.com

Medicare: Original, Replacement, Supplemental and Extra Crispy

Medicare Part B also covers outpatient hospital services including Emergency Room Visits and Hospital Observation. Generally, this means the patient pays a copayment for each individual outpatient hospital service. This amount may vary by service. The copayment for a single outpatient hospital service can’t be more than the inpatient hospital deductible. However, the total copayment for all outpatient services may be more than the inpatient hospital deductible. Part B also covers most of the doctor services when you’re a hospital outpatient. The patient pays 20% of the Medicare-approved amount after they pay the Part B deductible. Generally, the prescription and over-the-counter drugs received in an outpatient setting (like an emergency department), sometimes called “self-administered drugs,” aren’t covered by Part B. Also, for safety reasons, many hospitals have policies that don’t allow patients to bring prescription or other drugs from home. If the patient has Medicare prescription drug coverage (Part D), these drugs may be covered under certain circumstances. The patient likely will need to pay out-of-pocket for these drugs and submit a claim to their drug plan for a refund.
Source: managemypractice.com

CMS letter on Illinois retiree Medicare supplemental.

Although every individual has different needs, the news of the plan produced an audible sigh of relief among the nearly 400 hundred delegates of the Illinois Retired Teachers Association meeting today and tomorrow in Springfield.
Source: wordpress.com

Does Medicare Supplemental Insurance Suit Your Needs?

Those aged 65 and older can rely on traditional Medicare Parts A and B to pay for a broad array of healthcare services and supplies, though by no means will everything be covered. For this reason, it may be wise for such individuals to purchase a supplemental insurance policy to pick up the slack. This type of policy, also referred to as Medigap coverage, is sold by private carriers and is intended to take care of payment for things that traditional Medicare does not include. Such expenses include co-pays, annual deductibles and coinsurance. Certain available Medigap policies also provide coverage for services that have no coverage whatsoever under traditional, original Medicare.
Source: kurafire.net

Medigaplist.com Announces Medicare Supplemental Insurance AgentLive Insurance News

Specifically, the Package will offer a series of solutions to common problems, faced by Agents wanting to utilize the internet for marketing and exposure. This includes original content and lead generation, which is handled by in house developers, who use a proven system in generating traffic in specific areas and demographics. Furthermore, agents will have exclusive access to the leads generated, and will not be subject to any fees or commissions. Finally, upon completion of the sites creation, agents will have access to marketing and sales training seminars hosted weekly. This package offers everything from marketing materials to sales training. In short, it is a instant digital franchise solution that even veteran agents can take advantage of.
Source: liveinsurancenews.com

BGR Medicare Supplemental Insurance Plan N

A good number of MA plans provide a network along with medical service service providers. With some plans, you have to help you get your sickness services from the perfect network medical business provider in place for those firms to be coated. With some relating to the plans, owners may choose in order to really leave the network, but you quite possibly have to ante up more for layered services. when you see just that your own top doctors are before hand on the plan, you may always more satisfied complete with the network. If you would definitely rather have further freedom to decide between and choose doctors, you may no more be happy that has this type including restriction. This fact is actually quite similar to the very way PPO nor HMO plans effort on regular nicely being insurance policies.
Source: acsad-bgr.org

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November 18, 2013

UNITED STATES WILKINS v. UNITED HEALTH GROUP INCORPORATED, No. 10–2747., June 30, 2011

Posted by:  :  Category: Medicare

Appellants assert that 42 C.F.R. § 423.509, pursuant to which CMS may terminate a contract with a Medicare sponsor that fails to comply with the applicable marketing guidelines, demonstrates “[t]he relevancy and materiality of compliance” with the marketing guidelines. Appellants’ br. at 23. Indeed, section 423.509 states that “CMS may at any time terminate a contract if CMS determines that the Part D plan sponsor ․ [s]ubstantially fails to comply with ․ [m]arketing requirements in subpart V of this part.” 42 C.F.R. § 423.509(a)(8)(i); 42 C.F.R. § 422.510(a)(11) (same for MA organization). The same regulation, however, provides that before CMS may issue a notice of intent to terminate a Medicare contract it will provide a plan sponsor “a reasonable opportunity of at least 30 calendar days to develop and implement a corrective action plan to correct the deficiencies.” 42 C.F.R. § 423.509(c)(1)(i); 42 C.F.R. § 422.510(c)(1)(i). The regulation further provides, in section (c)(2)(iii), an exception for the 30–day correction period if the termination is based on “credible evidence, [that the Plan Sponsor] has committed or participated in false, fraudulent, or abusive activities affecting the Medicare, Medicaid, or other State or Federal health care programs, including submission of false or fraudulent data.” 42 C.F.R. § 423.509(a)(4); 42 C.F.R. § 422.510(c)(2)(iii) (referring to 42 C.F.R. § 422.510(a)(4)). The regulation also contains an exception to the requirement that a sponsor be allowed a 30–day correction period where CMS’s delay in termination, or the financial difficulties of the Plan Sponsor, pose an imminent and serious risk to the health of the individuals enrolled in the sponsor’s plan. 42 C.F.R. § 423.509(c)(2)(i)-(ii); 42 C.F.R. § 422.510(c)(2)(i)-(ii). Thus, sections 423.509 and 422.510 clearly demonstrate that compliance with the marketing regulations is a condition of participation and not a condition of payment as the regulations draw a line between the type of violations which are correctible and, if corrected, will allow the sponsor to continue as a Medicare program participant and the type of violations which lead to immediate termination of a CMS contract.
Source: findlaw.com

Video: GBMC Primary Care – Debbie Jones, CRNP

Tax Evasion and Medicaid/Medicare Fraud : South Carolina Nursing Home Blog

Since all Ameri-Choice checks come from the United Health’s home office they should be held equally responsible for any bribes, kickbacks, Stark, Fraud and inducements violations that may have occured. Federal and State Governments have developed such a depended position with this company, guess the laws and rules no longer apply for them. Protected vendor status sure, politics sure, limited government budgets sure, Federal and State officals looking the other way sure, and rather then stop these activities a strong desire not to rock the boat exists. The Government created this monster and now they don’t know what to do about it, like shooting yourself in your own foot etc. Tons of money to advance their national growth, its market positions, tons of money for political donations, tons of money to send 75 millon back to its home office from New York state alone, tons of money to suppot National TV shows, tons of money to pay hugh State fines, tons of money to hire the very best law firms, tons of money for hugh salarys and bonuses, all done on the back of the American taxpayor, you see this company receives all its money from the Federal State governments.
Source: scnursinghomelaw.com

Medicare Targets Health Plans With Low Ratings

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

Dr. Helen: “Can you, doctor, be our ‘yes man?'”

The decision to opt out of Medicare is often a difficult one for doctors, but for this primary care physician, the decision was worth it (via Instapundit): This decision meant I might lose my shirt and put my home and small life savings at risk, something thousands of Americans in other professions do everyday. If they could take the risk, then my risk is nothing less than a trivial American story. The United States was built on this: a country of immigrants fleeing an “old establishment” to build something new. It’s a group of people declaring: “You can’t tax us without representation!” It’s a government that permits us to challenge established norms, challenge power without being jailed or shot. The question today in health care for all of us as patients is will we stampede towards the utopian ideal of “free care” while ignoring the predictable consequences that nothing is free. The question put to primary care doctors by Medicare is clear at the moment: Will you let us at Medicare regulate care, dictate “best” treatments and control individual health and choices since we know what’s best. Can you, doctor, be our “yes man?” Eight years ago I cast my vote and opted out of Medicare. Predictably my journey has not been easy but I have never regretted the decision. Me neither, about a year or so ago, I opted out of Medicare (no easy feat!) due to the paperwork, lack of control, frustration at having trouble getting paid, the regulations and a myriad of other reasons. It was a good decision that I do not regret. If Obamacare comes in, then doctors will have to decide to be “yes men,” or “Go Galt” as many health providers are doing.
Source: blogspot.com

Payer Update: UHC Sticks With Consult Codes

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Source: inhealthcare.com

Page not found : Health Reform Watch

Click on the blue links to play, click again to pause: Hatch-Waxman “Pay for Delay” Audio: Panelists included Michael Kades, Attorney Advisor, Federal Trade Commission; Charles A. Gallia, Counsel, Gibbons P.C.; Anastasia Winslow, Assistant General Counsel, Bristol-Myers Squibb; and David Opderbeck, Associate Professor of Law and Director, Gibbons Institute of Law, Science & Technology. Hunt Lecture: From the original post: During his week-long visit to Seton Hall Law School, Paul Hunt, Professor of Law, University of Essex School of Law, provided several lectures to students and faculty …Read More Maizel Lecture: From the original post: A noted expert in the restructuring of health care business debts, both in and out of court, Sam Maizel treated Seton Hall to a one hour crash course on the fiscal crisis …Read More PPACA Discussion: From the original post: On Friday, April 9th, Seton Hall was treated to an expert round table discussion on the new health reform measures. Visiting professor Tim Greaney …Read More
Source: healthreformwatch.com

Philly Officer Crocket Charged With Theft, In Mental Institution

Three years ago they were reported to these Federal agency’s and as of todays date not only were they allowed to continue doing business but were never charged once. Protected vendor status sure, politics sure,limited government budgets sure, Federal and State officals looking the other way sure, and rather then stop these activities a strong desire not to rock the boat existed. Even with the vast changes in the laws and budgets,a hands off policy remains, you tell me what’s wrong with this picture? The Government created this monster and now they don’t know what to do about it, like shooting yourself in your own foot etc. Tons of money to advance their national growth, its market positions, tons of money for political donations, tons of money to send 75 millon back to its home office from New York state alone, tons of money to suppot National TV shows, tons of money to pay hugh State fines, tons of money to hire the very best law firms, tons of money to pay for bribes and kickbacks, tons of money for hugh salarys and bonuses, all done on the back of the American taxpayor, you see this company receives all its money from the Federal government. Should your tax dollars be held to a higher standard? Should the government agencys responsible for there review be held to that same standard?Should the IRS audit their corruption? Why has this company not been charged? How long can the buck be passed here in more ways then one? Hey, it’s your tax dollars don’t complain now then don’t complain later.tax dollars for bribes // Oct 6, 2010 at 8:57 am
Source: philadelphiaweekly.com

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November 18, 2013

The Chicken Hammer Blog: Medicare, Part “G”

Posted by:  :  Category: Medicare

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You’re a sick senior citizen and the government says there is no nursing home available for you. So what do you do? Our plan gives anyone 65 years, or older, a gun (G) and 4 bullets. You are allowed to shoot four Politicians. Of course, this means you’ll be sent to prison, where you will receive three meals a day, a roof over your head, central heating and air conditioning and all the health care you need.  Probably even cable TV… Need new teeth? No problem. Need glasses? That’s great. Need a new hip, knees, kidney, lungs or heart? They’re all covered. As an added bonus, your kids will come and visit you more often than they do now. And who will be paying for all of this? The same government that just told you they can’t afford for you to go into a home. And, you can get rid of four useless politicians while you’re at it. Plus, because you are a prisoner, you don’t have to pay income taxes anymore.
Source: chickenhammer.com

Video: Medicare Supplement Plan G – A Money Saving Alternative To Plan F?

Medicare Supplement Plan G

2011 2012 AARP about Auto Beautiful BENEFITS Best bill Capital care companies Company Conference Cool Find from Good Group health images Insurance know League Life many Medicare members Michigan Municipal Nice Obama photos pics pictures Plan Plans reform senior Seniors Should Supplement Supplemental their there
Source: wordwd.com

Seniors See Value in Medicare Supplement Plan G

Why would an insurance company charge a consumer $500 to cover a $147 expense? The better question might be; why would anyone pay it? The answer to the first question is two-fold, first of all, because they can and secondly, because of Federal laws which require Medicare supplement companies to accept without underwriting individuals losing group insurance and/or leaving a Medicare Advantage plan, companies incur greater claims losses since they can’t weed out the sick individuals. This law does not apply to Medicare Supplement Plan G. Now to answer the question, why would anyone pay so much to cover such a little difference? The answer is simply because they don’t know any better. Whose fault is it that they don’t know any better? That blames rests on the consumer themselves for not doing adequate research, the insurance agent who is not knowledgeable or unscrupulous, the insurance company which is profit driven and the Medicare system for not providing proper education.
Source: askmedicareblog.com

New Jersey Medicare Insurance Plans

Medicare supplement NJ is different because their rates are one of the lowest in the country. For example Jane is sixty six years old and on her way to see her grandchild she has a stroke and is in an accident. The hospital needs three pints of blood for a transfusion and she is charged for ten days in hospital. The stroke requires her to go for speech therapy once a month. Had she taken just plan A she would have had to pay one thousand one hundred and eighty four dollars towards her hospital bills while Medicare covered the rest as well as three pints of blood. Her speech therapy would have cost one hundred and forty seven dollars plus twenty dollars for each visit. Plan A would only pay for eighty percent of the cost.
Source: illinoiscaresrx.com

Medigap Insurance Plans In California

Medigap insurance Plan H has more coverage for prescription drugs. Apart from this significant well-being coverage this well-being plan also includes simple benefits coverage, adequate supplemental coverage for Medicate Component A plan, and well-being like issue coverage during foreign venture etc. Medigap insurance plan-I covers prescription drug benefits and in addition to this benefit also takes like for well-being like benefits during foreign travel, recovery coverage at home, and 100% coverage of excess charges below Medicare Be plan. Medigap Plan-J covers simple benefits, supplemental coverage below Medicare plan A and B, well-being emergency requirement while in foreign travel, at-home recovery process, coverage for preventive care, coverage for prescription drugs, and done coverage of excess charges incurred below Medicare Part-B plan. Medicare plan and ndash;J offers simple benefits, supplemental coverage for plan And B, well-being like coverage during foreign travel, recovery cost at home, and done coverage for excess charge included in Medicare Component Be plan, coverage for prescription drug and preventive like etc.
Source: typepad.com

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November 18, 2013

Ordering and Referring Providers: CMS Just Won’t Take No for an Answer. Form 855

Posted by:  :  Category: Medicare

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As of May 1, 2013, physicians and other providers (collectively “Providers”) who bill Medicare must list the NPI of the ordering/referring Provider on their claim forms in order to be paid for the technical component of imaging services, the technical component of clinical laboratory services, durable medical equipment and/or home health services.  An issue arises when the referring/ordering Provider does not participate with Medicare, and does not have an active NPI.
Source: floridahealthcarelawfirmblog.com

Video: Scope of Appointment Form Medicare Advantage

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

WakeMed & Key Physicians to Form Medicare ACO

Key Physicians, an organization of more than 220 independent physicians located in Wake, Durham, Orange and Johnston Counties, and WakeMed Health & Hospitals have signed a letter of intent to form WakeMed Key Community Care, a Medicare Shared Savings Accountable Care Organization (ACO). “By forming an ACO of Key Physicians’ extensive primary care network and WakeMed’s inpatient and outpatient services, clinical resources, and physicians, we will help facilitate patient access to a coordinated healthcare team focused on delivering efficient, quality care at a reasonable cost,” says John Rubino, MD, president of Key Physicians. “While patients will retain access to all of the region’s hospitals, they will benefit from an overall strategy to provide a more seamless experience regardless of where the care is delivered.”
Source: tac-consortium.org

Form drafted for new Medicare tax

Sixty years ago Tripp Plastics began as a two-man, plastic fabrication business. As our growth began, we realized we needed a reliable CPA firm capable and willing to expand to help us grow. Tripp Enterprises hired Barnard, Vogler & Co. With their accounting supervision, we have grown to a 200,000 square foot, international business …
Source: bvcocpas.com

Massachusetts / Rhode Island NATP Chapter: New IRS Form 8959

The IRS has issued a draft of its new Form 8959 which will be used to calculate the portion (if any) of the Medicare Tax W-2 withholding which may be applied against income tax liability arising from the 3.8% surtax on certain high-income taxpayers. The issue for taxpayers and tax preparers is that the medicare surtax is an addition to the regular income tax which applies, so it is included in the calculation of required payments/withholding necessary to avoid an underpaid tax penalty.  If the payroll system gets it right and withholds more than the otherwise required 1.45% on payroll to which the surtax applies, the Form 8959 then Identifies this supplemental medicare withholding included in box #6 on the W-2 form and reports it as part of the total federal income tax withholding on line #62 of Form 1040. Likewise, there is a separate section on the form for calculating the portion (if any) of the medicare tax on self-employment and/or railroad retirement income which is supplemental and, therefore, eligible for reclassification as income tax withholding reported on line #62. This form, although complicated in presentation because almost everything associated with Obama Care is complicated, appears to be something which good tax preparation software can handle without the active involvement of the tax preparer.
Source: blogspot.com

Patrick Henry: THE DEMOCRATS FORM OF GOVERNMENT THAT IS CORRUPTION WAITING TO POINT OUT THE OBVIOUS AFTER THE DAMAGE HAS BEEN DONE

“… It is only in this way that we can hope to arrive at truth, and fulfill the great responsibility which we hold to God and our country. Should I keep back my opinions at such a time, through fear of giving offense, I should consider myself as guilty of treason towards my country, and of an act of disloyalty toward the Majesty of Heaven, which I revere above all earthly kings.”….I know not what course others may take; but as for me, give me liberty or give me death!”
Source: blogspot.com

Income Thresholds For Medicare Part B And Part D Premiums

While the surtax due to higher Medicare premiums that resulted from the Roth conversion was not huge, at only 1.6%, it nonetheless represents an entirely manageable – and potentially avoidable – surtax that planners and clients should carefully consider. For instance, the client might have decided to convert only $27,000 in the prior example – rather than $39,350 – to keep from exceeding the $87,000 AGI threshold that triggers the first Medicare premium increase, allowing the conversion to have a cost of "only" the 25% marginal tax bracket, and not 26.6%. On the other hand, if the client’s income was higher, the impact would have been more severe. For instance, if AGI was already $85,000, then a $5,000 conversion would result in $1,250 of taxes (at a 25% tax) plus the same $619.20 (for additional Medicare premiums), which leads to a marginal "tax" of $1,869.20 and a marginal tax rate of 37.4%; on the other hand, if the conversion was $10,000, the marginal rate would only be 31.2% (since the additional taxes would rise to $2,500 but the Medicare premium impact would still be the same $619.20/year). The end result: the closer clients are to an income threshold, the better it is to either stay right below the line, or rise far above it until the next threshold (or a new tax bracket) approaches, because the additional Part B and Part D premiums are a flat additional amount even if clients are just $1 across the line (unlike tax brackets, which are always a percentage of additional income). And because the premium adjustments are calculated based on AGI, anything that increases AGI can impact exposure, from IRA withdrawals and Roth conversions, to capital gains, to dividends and interest and income from pass-through entities; on the other hand, any deductions that are taken above the line, such as capital losses or certain business losses, can also reduce exposure.
Source: kitces.com

Romney Lies About Medicare/Medicaid Change Of Address Form

There were periods during my government service when the business-does-it-this-way was fashionable.  Public private partnership (acronym PPP) became popular.  At some point what tended to happen or be realized was the understanding that the public service does not have, cannot have the same “bottom line” as a for-profit organization.  Wall Street exemplifies the outsize for-profit situation these days…I do not think most people want the government to emulate that value system when it comes to exercising government authority.  And, frankly, when you look at it, the basic myth at bottom of the business school takeaway about efficiency has a lot of flaws…not the least of which is that large, major corporations with their overpayment of failing executives and with their taking-care-of-the-top first motif are the opposite of even the the narrowest definition of “efficiency.”  
Source: talkleft.com

Has anyone else encountered QuickBooks calculating

While preparing the third quarter form 941 my Payroll Summary report has the correct additional medicare tax calculated but when I go into prepare form 941 line 5d has the incorrect Taxable wages and tax calculation.  Has anyone else encountered this problem?
Source: intuit.com

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