Medicare Secondary Payer Training

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The training covered the Medicare Secondary Payer Act, Mandatory Insurer Reporting, Conditional Payment Resolution, Workers’ Compensation Medicare Set Aside Allocations, Liability Medicare Set Aside Allocations, Conditional Payment Resolution for Medicare Part C beneficiaries, Post Settlement Administration of Medicare Set Asides and Special Needs Trusts and finally, compliance with the SMART Act.
Source: il.us

Video: Medicare Agent Training

AP GOVERNMENT AND POLITICS: How Medicare Subsidizes Doctor Training

Medical residencies are subsidized by Medicare. Medicare was established in 1965 by Congress. Congress set up payments to subsidize residencies “until the community undertakes to bear such educations costs in some other way.” The meaning of this is very unclear. It proposes questions such as: Who is the “community” and why would it voluntarily take over this large financial responsibility if the federal government was already paying for it? Needless to say, Medicare devised a new version of the training that is composed of two parts. The first part is for “direct” costs of training new doctors (their salaries, benefits, and teaching costs). The second part, is suppose to pay for “indirect” costs that hospitals and health care centers incur because trainees are expected to be slower and inefficient. If a patient comes in with an ailment that Medicare usually pays $2,000 for the hospital to treat, Medicare will pay more if the hospital employs lots of residents. The point for this is that hospitals use incentives to create new residency slots, so they could get higher payment rates from Medicare. Congress disagreed with this, saying it was financially unsustainable. During the 1990s, there was also concern about creating an oversupply of doctors. In 1997, Congress limited the number of positions that Medicare could underwrite. In other words, hospitals can create non-Medicare-financed residency slots, but they have to do so using their own source of funds. There has been debate about whether hospitals need these subsidies, because at some point in the training process residents are most likely bringing in large sums of money for the hospital. The Medicare Payment Advisory Commission has found that the indirect payment rate is twice as high, when one looks at costs of care at teaching hospitals versus nonteaching hospitals. Medicare subsidies for graduate medical education averaging of $112,642 per resident, which is around $10.1 billion annually. The Northeast is also the biggest beneficiary of this type of funding system. In 2010, there were 77.13 Medicare sponsored residents for every 100,000 people living in New York. In Montana there were 1.63 residents per 100,000 people.  Connecticut has the highest subsidies per resident ($155,135 per resident compared to $63,811 per residence in Wyoming). Medicare-financed residency are primarily centered in the Northeast, however the expansion of medical school enrollment has been concentrated in the South. Here is the issue: new or expanding medical schools have faced a barrier because their residency program base is very small and the lack Medicare gradate medial education funding (G.M.E) to expand. The state will have to fund the G.M.E positions or the new graduates will have to leave the state to find residency positions. What are your thoughts? Do hospitals need these subsidies? Should Medicare help cover residency programs? Should the responsibility be left up to the states, the hospitals? Do you think it is fair graduates may have leave their state to find residency programs? http://economix.blogs.nytimes.com/2013/12/17/how-medicare-subsidizes-doctor-training/?src=recg&_r=0
Source: blogspot.com

Advice from Benjamin Franklin | Medicare Training

Aetna cancer cigna closing CMS conference call CSI dental Draft Dates e-app Effective Dates electronic application equitable equitable life final expense final expense by phone foresters guaranteed issue hearing Heartland National Hospital Indemnity Interview life insurance medicare advantage medicare supplements medicare supplement training medico mutual of omaha New Era New Era Life objections orlando event oxford life Part D Plan F Plan F vs. Plan G Plan G planright predictive dialer Send Out Cards stonebridge training Underwriting vision webinar
Source: medicareagenttraining.com

Dartmouth study: 1/4 Medicare patients fill Rx considered high risk. Will ICD

This article talks about the type of trends than can help us improve the quality of healthcare. As stated by my medical school Alma mater, Dartmouth, and their Atlas group, Quality in health care means doing the right things right. Unfortunately, traditional efforts focus on just doing things right, and with ICD-10, and a better understanding of the patient, additional trends like this can be identified, and targeted training delivered to correct inappropriate prescribing habits. Just as importantly, the increased detail with ICD-10 can help us better risk stratify patients, for inclusion or exclusion from these types of analysis, that can impact hospital and provider ratings. Although capturing that level of detail with our documentation is already frustrating, and time consuming, our ability as a nation to identify more trends to help our citizens is greatly limited by ICD-9. As scientists studying trends, it is also our responsibility to publish data, that accounts for all possible confounding factors, not just those that can be captured by ICD-9 which we adopted in 1979. The key to this all of course is training physicians to appropriately document not only in ICD-9 today, but in ICD-10 next year. In addition, supplementary training on the EHR to facilitate ICD-10 use, either through active problem selection, or simply documenting a note efficiently should not be overlooked in conjunction with training to support new documentation requirements. When documentation in your EHR is slow, I can tell you from experience with over 100 EHR implementations, and developing training for hundreds of thousands of medical professionals, inefficiency with the EHR is never 100% due to the EHR. Training is essential for efficiency with any tool, and if we are to further empower population health experts with data to uncover inefficiencies and improve quality, training is central, should be comprehensive and continual, targeting specific deficiencies when encountered or discovered to be important. Like a negative feedback loop!
Source: implementhit.com

CMS National Training Program Medicare Workshop 2013

September 10-11, 2013 Doubletree by Hilton Buckhead Atlanta, GA The 2013 CMS National Training Program Workshop is offering free CMS training. What will be presented this year: • Both high-level and detailed information about key aspects of the Medicare program • A half-day basic track for those who are new to Medicare or who want a refresher • A “Current Topics” session to raise awareness of program changes • An introduction to the new Health Insurance Marketplace • Casework exercises • Medicare training modules and workbooks • Networking opportunities with CMS staff and other partners who share your commitment More information on program and logistics available soon, including information to book hotel accommodations at the group rate. This session does not fulfill the certification requirements for Navigators or other assisters, or for agents and brokers. The training that does provide certification for the Marketplace will be web based and be accessible in August. NOTE: Registration requests will be considered on a first come, first served basis until each meeting reaches capacity. The number of attendees from the same organization may be limited.
Source: gaobgyn.com

Does Medicare Cover Diabetic Supplies?

Medicare Part B, also known as medical insurance, covers certain blood glucose self-testing supplies, including blood glucose test strips, meters, lancets, and glucose control solutions. It also covers diabetes screenings if a doctor determines that a beneficiary is at risk for diabetes. Part B also covers outpatient education for those who are at risk for complications from diabetes or who were recently diagnosed and need training on how to manage their condition. Specifically, Medicare Part B covers:
Source: ehealthmedicare.com

Oklahoma Eliminates Medicare Renewal Training Requirement

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

S.1468: Medicare Diabetes Self

8/2/2011–Introduced.Medicare Diabetes Self-Management Training Act of 2011 – Amends title XVIII (Medicare) of the Social Security Act to recognize state-licensed or -registered health care professionals who are certified diabetes educators in an outpatient setting as authorized providers of Medicare diabetes outpatient self-management training services, including as part of telehealth services, under Medicare part B (Supplementary Medical Insurance). Directs the Comptroller General to study the barriers that exist for Medicare beneficiaries with diabetes in accessing diabetes self-management training services under the Medicare program. Directs the Director of the Agency for Health Care Research and Quality of the Department of Health and Human Services (HHS) to develop a series of recommendations on effective outreach methods to educate primary care physicians and the public about the benefits of diabetes self-management training.
Source: opencongress.org

More on residency training slots

That may have been the case in the past, but not anymore. There has been a huge shift toward outpatient management of many things that used to lead to admission. Residents headed for spend a lot of their time working in outpatient venues. The misunderstanding comes perhaps because people do Internal Medicine followed by specialty training. Some Medicine residents go into general internal medicine while others become specialists. They may be on different tracks even during their residencies, but in any case neither group spends all its time on the inpatient service. Medicine has not been practiced like that for a long time.
Source: theincidentaleconomist.com