DMEPOS Competitive Bidding

Posted by:  :  Category: Medicare

Under the program, a competition among suppliers who operate in a particular competitive bidding area is conducted. Suppliers are required to submit a bid for selected products. Not all products or items are subject to competitive bidding. Bids are submitted electronically through a web-based application process and required documents are mailed. Bids are evaluated based on the supplier’s eligibility, its financial stability and the bid price. Contracts are awarded to the Medicare suppliers who offer the best price and meet applicable quality and financial standards. Contract suppliers must agree to accept assignment on all claims for bid items and will be paid the bid price amount. The amount is derived from the median of all winning bids for an item.
Source: cms.gov

DME Competitive Bidding Program

The Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program. Qualified, accredited suppliers with winning bids are chosen as Medicare-contract suppliers.
Source: medicare.gov

Competitive Bidding Program

The Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it pays for those equipment and supplies under the Competitive Bidding Program. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers.
Source: medicare.gov

Medicare National Competitive Bidding Program

CCS Medical is one of only 18 suppliers awarded CMS contracts to provide mail order diabetic testing supplies at competitively bid prices nationwide and in the four U.S. territories (American Samoa, Guam, Puerto Rico, and the U.S. Virgin Islands). As announced previously by CCS Medical, one of the brands that CCS Medical will be carrying is LifeScan’s OneTouch® Ultra® test strips, the No. 1 brand recommended by endocrinologists and diabetes educators.
Source: ccsmed.com

Medicare Expands Competitive Bidding Program for Durable Medical Equipment

You can also get the supplies from a store or pharmacy that accepts "Medicare assignment." This means that the store will accept the Medicare-approved amount as payment in full and that you cannot be charged more than a 20 percent copay (after you meet your annual deductible). A Medicare contract supplier can’t charge you more than that for the equipment or supplies included in the competitive bidding program.
Source: aarp.org

: DMEPOS Competitive Bidding : Health Industry Washington Watch

CMS has just released a proposed rule that would require Medicare prior authorization (PA) for certain Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items that the agency characterizes as “frequently subject to unnecessary utilization.“ As part of the rulemaking, CMS has developed a “Master List” of initial items that it considers to meet this standard based on being (1) identified in a GAO or HHS OIG national report published in 2007 or later as having a high rate of fraud or unnecessary utilization; or (2) listed in the 2011 or later Comprehensive Error Rate Testing (CERT) program’s Annual Medicare FFS Improper Payment Rate Report DME Service Specific Overpayment Rate Appendix. CMS also proposes limiting the items on the Master List to those with an average purchase fee of at least $1,000 or an average rental fee schedule of at least $100 to allow CMS to focus on items with the largest potential savings for the Medicare Trust Fund. CMS proposes that the Master List will be “self-updating” annually, and that items generally will remain on the list for 10 years. Note, however, that presence on the Master List would not automatically require prior authorization. CMS would limit the PA requirement to a subset of items (called the “Required Prior Authorization List") “to balance minimizing provider and supplier burden with our need to protect the Trust Funds." CMS would publish the Required Prior Authorization List in the Federal Register with 60-day notice before implementation. CMS also proposes that the PA program could be implemented nationally or locally. The proposed rule does not announce the first items on the Required Prior Authorization List. Instead, CMS is seeking public comment on the number of items that should be selected initially and in the future, and the frequency with which CMS should select items.
Source: healthindustrywashingtonwatch.com

Cost Report Data provides hospital financial information from Medicare cost reports filed by hospitals and contained in the CMS HCRIS file

Posted by:  :  Category: Medicare

CostReportData.com provides online Medicare cost report data to healthcare financial and reimbursement professionals. Our database of more than 6,000 hospitals is built from Medicare cost report information obtained from the federal Centers for Medicare and Medicaid Services (CMS). Information is presented in familiar worksheet formats that can be viewed online, printed, and downloaded in Excel or pdf formats. Pricing is economical … whether you need data on a just few hospitals or unlimited access throughout the year. Use the site for free to look up a hospital and see the periods and worksheets available.  Click on Single Cost Reports to test drive and see how easy it is to have all cost reports since FY 1996 at your fingertips.
Source: costreportdata.com

Medicare.gov: the official U.S. government site for Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Medicare & Medicaid Cost Report l Owner Administrator Forum Seminar

Medicare Training & Consulting, Inc., was founded by Jim Plonsey in the Chicago area. After training Medicare auditors for Blue Cross Association, Jim established a business training Medicare auditors. This lead to doing cost reimbursement seminars for providers, most notably, home health agencies. Medicare Training & Consulting, Inc. has become a leader in providing Owners and Administrators with the reimbursement strategies.
Source: medicareconsulting.net

Medicare and Medicaid Cost Reports

For over 20 years, Brooks Financial Strategies has provided the most reliable cost reporting services in the industry. We often work with financial accountants or CPAs who complete the year-end financial statements for your agency.  These annual financial statements are then used to complete the Medicare or Medicaid cost report. We also work with healthcare providers to analyze costs per visit, revenue per visit, and break-even points. We compare healthcare agencies like yours to national state averages including nursing costs, therapy costs, administrative salaries, and net income.
Source: bksfin.com

Medicare Fraud Whistleblower Qui Tam Cases

Another common example of coding fraud is called “unbundling.” When procedures or lab tests involve a number of related services or tests that are typically performed together, Medicare and Medicaid have specific billing codes that must be used to obtain reimbursement for all of the associated services or tests as a whole, rather than allowing reimbursement for each of the related services or tests billed separately. For instance, blood and clinical laboratories often perform “Complete Blood Count” (“CBC”) testing as ordered by physicians. These “CBCs” usually involve up to a dozen or more tests for various enzymes, minerals, platelets, etc. However, because these CBCs are so common, the lab companies have a standard automated test that is used, rather than having to test for each component separately. Accordingly, Medicare billing codes include specific codes that must be billed to obtain a single reimbursement for all of these tests together. In the “unbundling” scheme, lab companies billing for each do not use the composite billing code, but instead bill multiple codes as though they had performed separate tests for each of the blood components. In this unbundling scheme, the lab fraudulently obtains much higher overall reimbursement than it is entitled to.
Source: warrenbensonlaw.com

Small Slice of Doctors Account for Big Chunk of Medicare Costs

"We look forward to making this important, new information available so that consumers, Medicare and other payers can get the best value for their health-care dollar," said Jonathan Blum, principal deputy administrator for the Centers for Medicare and Medicaid Services, in announcing the effort. Under an agreement with CMS, The Wall Street Journal obtained the data early this week, but agreed not to contact physicians or share findings of its analysis with third parties until Wednesday.
Source: wsj.com

Highmark Medicare Services is now Novitas Solutions

Posted by:  :  Category: Medicare

Physicians and medical billing companies should not face many disruptions as a result of this transition. According to Novitas Solutions, the current Highmark Medicare website will be fully transitioned to the new Novitas site by March 30, 2012. During the transition, visitors to the old website (https://www.highmarkmedicareservices.com) will be automatically re-directed to the new Novitas Solutions website (https://www.novitas-solutions.com), where a new header and page logo can be seen. Bookmarks that users may already have for the Highmark website will purportedly still work with the new page. The Electronic Payer ID has not appeared to change, so claims submission and processing should remain unaffected by the transition. For more information, see the Informational Alert here: https://www.novitas-solutions.com/partb/info-alerts.html.
Source: healthcarebiller.com

Highmark: Your Health Care Partner

Highmark Inc. is a national, diversified health care partner serving members through its businesses in health insurance, dental insurance, vision care and reinsurance. Our mission is to make high-quality health care readily available, easily understandable and truly affordable in the communities we serve.
Source: highmark.com

Highmark Medicare Services Inc Becomes Novitas Solutions Inc

Effective March 10, Novitas Solutions will begin to migrate the current HMS Web site to the new Novitas Solutions Web site, www.novitas-solutions.com. Novitas is targeting completing the name change to all active Web page content by March 30. Although main headers throughout the Web site will be changed, some historical documents, such as Medicare reports issued under HMS, will not be changed to reflect the new name.
Source: apta.org

Highmark Medicare Services Now Novitas Solutions

Effective January 1, 2012, Highmark Medicare Services (“Highmark”) was acquired by Diversified Service Options, Inc. (a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida, Inc.). As a result of the acquisition, Highmark changed its name to Novitas Solutions, Inc. (“Novitas”). Novitas will continue Highmark’s role as the Medicare Administrative Contractor (“MAC”) for J12 (Delaware, Washington, D.C., Maryland, New Jersey and Pennsylvania) and the Administrative Contractor for Section 1011. Though not operational at this time, the new website will be www.Novitas-Solutions.com. Click here for the informational alert from Highmark regarding the acquisition.
Source: healthlawattorneyblog.com

Highmark to Limit Access to UPMC for Medicare

UPMC East is a 156-bed full-service community hospital built to meet the growing demand for world-class care in the eastern suburbs. UPMC East will provide patient-centered clinical care and amenities with the latest technology and environmentally efficient design and construction. The hospital is synergistic with an array of outpatient healthcare services already provided by UPMC in Monroeville, including primary care and specialty physicians, advanced diagnostic services and outpatient surgery. UPMC East is expected to create more than 400 new jobs upon its opening.
Source: upmc.com

Highmark Direct :: Medicare Information

A Medicare Supplement policy is different from a Medicare Advantage Plan.  MA plans offer ways to get Medicare benefits, while a Medicare Supplement policy only supplements your Original Medicare benefits.  You can purchase a Medicare Supplement insurance plan from a private company to help pay for costs and services that your Original Medicare doesn’t cover.  In addition to helping offset Original Medicare’s high cost-sharing (copayment, coinsurance and deductible costs). Medicare Supplement policies may cover other services such as medical care during travel outside of the U.S.
Source: highmarkdirect.com

Novitas Solutions, formerly called Highmark Medicare Services, announces hundreds of health care jobs coming to Harrisburg, Pittsburgh areas

The prospect of new jobs arises from a large, new contract that was in limbo at the time of the sale. The contract, which involves administering Medicare claims for seven Southwestern states, was expected to create 500 new jobs in Pennsylvania, with about 260 coming to the Harrisburg area.
Source: pennlive.com

Health Insurance Made Simple

Posted by:  :  Category: Medicare

Our licensed Product Advisors can help you find a health plan that meets your needs and budget. You have a limited time to apply for Open Enrollment. Don’t delay! Open Enrollment begins November 15, 2014 Apply by December 15, 2014, to start coverage January 1, 2015 Open Enrollment ends February 15, 2015
Source: goldenrule.com

America’s Health Insurance Plans

Unadjusted inpatient hospital prices per admission grew by 8.2% per year from 2008 to 2010 for the commercially insured population (under age 65 years) in the MarketScan data set. We estimate that approximately 1.3 to 1.9 percentage points of the growth in prices can be attributed to increased intensity per admission. Thus, we estimate that intensity-adjusted price increases ranged from 6.2% to 6.8% annually in the 2008-2010 period. Price levels and trends varied considerably across admission types, states, and localities.
Source: ahip.org

Health insurance in the United States

The Pre-existing Condition Insurance Plan, or PCIP, is a transitional program created in the Patient Protection and Affordable Care Act (PPACA). Those eligible for PCIP are citizens of the United States or those legally residing in the U.S., who have been uninsured for the last 6 months and “have a pre-existing condition or have been denied health coverage because of their health condition.” However, if one has health insurance or is enrolled in a state high risk pool, they are not eligible for PCIP, even if that coverage does not cover their medical condition. PCIP is run by the individual states or through the U.S. Department of Health and Human Services, which has a contract with the Government Employees Health Association, or GEHA, to administer benefits. Both will be funded by the federal government and provide three plan options. These options are the standard, extended, and the Health Savings Account option. PCIP only covers the individual enrollee and does not include family members or dependents. In 2014, the Affordable Care Act provision banning discrimination based on pre-existing conditions will be implemented and PCIP enrollees will be transitioned into new state-based health care exchanges.
Source: wikipedia.org

Health Insurance Quotes, Medical Insurance, Affordable Health Insurance Plans

Brands You Know and Trust HealthPlanOne works with all major carriers. We are an Aetna “Premium Producer”, an Anthem “Premier Partner”, and a Humana “Strategic Alliance Partner”. We also work with Celtic, Cigna, Oxford, Unicare, Unitedhealthcare Life Insurance Company and Golden Rule Insurance Company and dozens of other health insurance companies.
Source: healthplanone.com

What Is Medicare Part C? (Medicare Advantage)

Posted by:  :  Category: Medicare

Medicare Part C, which is also called a Medicare Advantage plan and can and will be used interchangeably, is a healthcare plan that you sign up for through by a private insurance company and covers substantially all, if not more than what is covered by Medicare Part A and Medicare Part B combined. Obtaining a Medicare Part C plan is sufficient to meet the requirements and minimum standards imposed by Obamacare. Additionally, as opposed to working with the Social Security Administration’s office, a person who opts to sign up for Medicare Part C can shop around for plans on sources like MedicarePartC.com or can use the federal Marketplace set up on Healthcare.gov to purchase a plan.
Source: medicarepartc.com

What is a Medicare Advantage Plan

Medicare Advantage are private health plans that help with hospital costs, medical costs, and often prescription drug expenses. Once called “Medicare+Choice”, these plans became known as Medicare Advantage in 2003 due to the Medicare Prescription Drug, Improvement, and Modernization Act. Many plans offer additional benefits beyond traditional Medicare coverage. Premiums vary for Medicare Advantage plans and, in some areas, there are plans that offer Medicare Advantage benefits for no monthly premium (although all Medicare Advantage beneficiaries are still responsible to continue to pay their Medicare Part B premium).
Source: planprescriber.com

What is the purpose of medicare advantage?

Medicare Advantage Plans Medicare Advantage Plans are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through that plan. This coverage can include prescription drug coverage. Medicare Advantage Plans include: * Medicare Health Maintenance Organization (HMOs) * Preferred Provider Organizations (PPO) * Private Fee-for-Service Plans * Medicare Special Needs Plans When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, generally there are extra benefits and lower copayments than in the Original Medicare Plan. However, you may have to see doctors that belong to the plan or go to certain hospitals to get services. To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. If you join a Medicare Advantage Plan, your Medigap policy won’t work. This means it won’t pay any deductibles, copayments, or other cost-sharing under your Medicare Health Plan. Therefore, you may want to drop your Medigap policy if you join a Medicare Advantage Plan. However, you have a legal right to keep the Medigap policy. To compare Medicare Advantage Plans, go to the Medicare Options Compare.
Source: amazon.com

What is the Medicare Advantage maximum out pocket?

Ross Blair has applied more than 26 years of technology experience to develop PlanPrescriber.com, a website that makes it easier for seniors and their caregivers to select and enroll in the best Medicare products for their specific needs. In his role as CEO, he has worked closely with pharmacists, insurers, physicians, caregivers and seniors to identify the most critical and complex aspects of Medicare and create a system that delivers this information to consumers in a format that is easy to use and understand.
Source: ehealthinsurance.com

TEXAS MEDICAID APPLICATION

Posted by:  :  Category: Medicare

In order to participate in Medicaid, federal law requires states to cover certain population groups (mandatory eligibility groups) and gives them the flexibility to cover other population groups (optional eligibility groups). States set individual eligibility criteria within federal minimum standards. States can apply to the Centers for Medicare & Medicaid Services (CMS) for a waiver of federal law to expand health coverage beyond these groups. Medicaid is an entitlement program, which means the federal government does not, and a state cannot, limit the number of eligible people who can enroll, and Medicaid must pay for any services covered under the program. In December 2011, about one in seven Texans (3.7 million of the 25.9 million) relied on
Source: texasmedicaidapplications.com

Texas Medicaid/CHIP Vendor Drug Program

On February 1, 2015, VDP will change the fee-for-service (FFS) Medicaid reimbursement methodology for calculating the ingredient cost of pharmacy claims paid to eligible health care organizations participating in the Health Resources and Services Administration (HRSA) 340B Drug Pricing Program.  More about the 340B reimbursement changes.
Source: txvendordrug.com

Texas Medicaid: The Medicaid Project, Texas Medicaid Eligibility, Help, Assistance; TX

web site: Your Texas Benefits languages: English (no publication date is available) The navigation bar at the top of the page offers six subtopics about Texas Medicaid and other benefit programs. Clicking on “Common Questions” delivers a web page of numerous FAQ’s about applying for and receiving benefits, along with telephone contacts and instructions for using the website. Back at the home page, there is a short form you can complete to find out what benefits you might be eligible for. If you are receiving benefits already, or have applied for them, you can also view details about your case. This feature requires a security log-in and password.
Source: quickbrochures.net

America’s Health Insurance Plans

Posted by:  :  Category: Medicare

Unadjusted inpatient hospital prices per admission grew by 8.2% per year from 2008 to 2010 for the commercially insured population (under age 65 years) in the MarketScan data set. We estimate that approximately 1.3 to 1.9 percentage points of the growth in prices can be attributed to increased intensity per admission. Thus, we estimate that intensity-adjusted price increases ranged from 6.2% to 6.8% annually in the 2008-2010 period. Price levels and trends varied considerably across admission types, states, and localities.
Source: ahip.org

Get your :: CHEAP HEALTH INSURANCE PLAN :: right here today!

If you were in good health. Group members often are able to establish a captive client base. Thus, they encourage each of you to have the money you contribute will continue to receive those payments. Health insurance plans, you will get a simple increase benefit also costs much. Others charge a lesser amount for each individual insured, or for a long term Care administered in the process of doing so. Respite care: When a patient is admitted to the price and coverage of the solutions that have contracted with the group. A 65-year-old woman would pay $10.35 per month, and have to, too. Some policies utilize a version of the insurance company considers to be completed that helps individuals determine if Long. The Canadian health Act penalizes physicians and hospitals you use a gastroenterologist outside the network.
Source: allhealthinsurers.net

Health insurance in the United States

The Pre-existing Condition Insurance Plan, or PCIP, is a transitional program created in the Patient Protection and Affordable Care Act (PPACA). Those eligible for PCIP are citizens of the United States or those legally residing in the U.S., who have been uninsured for the last 6 months and “have a pre-existing condition or have been denied health coverage because of their health condition.” However, if one has health insurance or is enrolled in a state high risk pool, they are not eligible for PCIP, even if that coverage does not cover their medical condition. PCIP is run by the individual states or through the U.S. Department of Health and Human Services, which has a contract with the Government Employees Health Association, or GEHA, to administer benefits. Both will be funded by the federal government and provide three plan options. These options are the standard, extended, and the Health Savings Account option. PCIP only covers the individual enrollee and does not include family members or dependents. In 2014, the Affordable Care Act provision banning discrimination based on pre-existing conditions will be implemented and PCIP enrollees will be transitioned into new state-based health care exchanges.
Source: wikipedia.org

Health Insurance Quotes, Medical Insurance, Affordable Health Insurance Plans

Brands You Know and Trust HealthPlanOne works with all major carriers. We are an Aetna “Premium Producer”, an Anthem “Premier Partner”, and a Humana “Strategic Alliance Partner”. We also work with Celtic, Cigna, Oxford, Unicare, Unitedhealthcare Life Insurance Company and Golden Rule Insurance Company and dozens of other health insurance companies.
Source: healthplanone.com

Health Insurance Made Simple

Our licensed Product Advisors can help you find a health plan that meets your needs and budget. You have a limited time to apply for Open Enrollment. Don’t delay! Open Enrollment begins November 15, 2014 Apply by December 15, 2014, to start coverage January 1, 2015 Open Enrollment ends February 15, 2015
Source: goldenrule.com

Health Insurance Premiums and Premium Costs by State

Posted by:  :  Category: Medicare

Health Insurance Marketplace (Exchange) Premiums for 2014 – Released by HHS September 25, 2013.  This report summarizes the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains new information, current as of September 18, 2013, on qualified health plans in the 36 states in which the Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014. [NCSL Note: this omits all 14 state-run exchanges.] Plan data is in final stages but is still under review as of September 18 and may be revised in HHS systems before being displayed for consumers, so this information is subject to change. This analysis also includes similar information that is publicly available from 11 states and the District of Columbia that are implementing their own Marketplace. This report focuses on the plans with the lowest premiums in each state, as consumers are expected to shop for low-cost plans. Nearly all consumers (about 95%) will have a choice of 2 or more health insurance issuers (often many more) and nearly all consumers (about 95%) live in states with average premiums below earlier estimates.  Online Printer friendly version in PDF format (15 pages).
Source: ncsl.org

COBRA Health Insurance Continuation Premium Subsidy

In addition, the COBRA subsidy is available to people who become eligible for COBRA coverage as a result of a reduction in hours occurring between Sept. 1, 2008, and May 31, 2010, followed by an involuntary termination between March 2, 2010 and May 31, 2010. If you fall into this category, your subsidy is available starting with the first period of coverage beginning after the involuntary termination. Individuals who did not take COBRA coverage after the reduction in hours or who signed up but later dropped it, get another chance to sign up for COBRA coverage. In this case, the COBRA coverage would begin with the first period of coverage after the involuntary termination and continue up to 18 months after the reduction in hours. The administrator of a group health plan or other entity must provide notice of the new election right after the involuntary termination. As in the case of other assistance-eligible individuals, the subsidy ends after the earliest of 15 months, the end of COBRA coverage, or eligibility for other group health or Medicare coverage.
Source: irs.gov

Rate Shock: In California, Obamacare To Increase Individual Health Insurance Premiums By 64

The author has done a lot of analysis but failed to do research. However he is equally guilty of comparing apples to oranges and clearly has group coverage. Any individual who applies for insurance on E-health or one of the large nationals, NEVER gets the cheapest rate. It is a teaser rate or only for those in perfect health which simply does not exist. You cannot lie on the application due to the pre-existing clauses which will result in NO coverage at all shld. you have a health mishap due to your condition. The insurance companies ALWAYS add a risk premium to the lowest rate offered (BAIT and SWITCH) just like some car dealers and one always pays $80 plus or more depending on the risk factors the insurers add such as age, hypertensive, location, amount of meds you are currently one and so on. I was 51 in 2009 and applied for catastrophic insurance with Anthem BCBS in Ga. and the rate advertised was $130 or something but after the application I ended up paying $260 a month. Another co. would only provide insurance to me if I signed a WAIVER of coverage for a pre-existing condition for life. I applied to 4 different insurers and each time the advertised premium was not available to me and only for someone in perfect health.
Source: forbes.com

Health Insurance Marketplace Calculator

The premium tax credit helps lower your monthly expenses.  This subsidy is available to people with family incomes between 100% and 400% of the poverty level who buy coverage through the Health Insurance Marketplace. These individuals and families will have to pay no more than 2.01% – 9.56% of their incomes for a mid-level plan (“silver”) premium.  Anything above that is paid by the government. The amount of your tax credit is based on the price of a silver plan in your area, but you can use your premium tax credit to purchase any Marketplace plan, including Bronze, Gold, and Platinum plans (these different types of plans are described below). You can choose to have your tax credit paid directly to the insurance company so that you pay less each month, or, you can decide to wait to get the tax credit in a lump sum when you do your taxes next year.
Source: kff.org

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Get Medicare Part D Quotes in Seconds

As could be expected, prices for Humana policies rocketed for the 2014 calendar year. Mean premiums for Humana Part D jumped from $21.80 to $38.70. Medicare Part D is priced at $41.55 and Part D Medicare comes in at the slightly lower price of $38.80. Humana’s standalone market share coverage has dropped to 18.6% whereas their Medicare Part D policies have increased to a market share of 12.8%.
Source: medicareaide.com

Medicare Plans are Confusing, We Make Medicare Less Frustrating.

Medicare Advantage insurance is a replacement to Original or Traditional Medicare Parts A and B – it is offered instead by private insurance companies. Medicare Advantage plans generally feature additional benefits and have less cost-sharing than Traditional Medicare, and you may be required to pay a monthly premium in exchange for the added benefits that the Medicare Advantage plan features. Medicare Advantage plans come in many different flavors and formats such as: HMO plans, PPO plans, PFFS plans, and special needs plans. Seniors may only enroll in Medicare Advantage plans if they already have both Medicare Part A and Medicare Part B and then only during specially designated enrollment periods. The Medicare enrollment periods change often, so please call us at: 1-(866)-866-7951 to find out when the next open enrollment period starts so you can enroll in this type of Medicare Plan.
Source: medicareplanstoday.com

Medicare Resource Center: learn about Part D, Advantage, Medigap and more

Throughout the recent health care debate, Americans heard that health reform could weaken or even wipe out Medicare. Now, with the passage of the Affordable Care Act, experts say the reforms will likely strengthen Medicare and extend its life to 2029. That’s good news, considering that millions of Americans now pay into Medicare through payroll taxes and are anxiously waiting to become eligible for its benefits.
Source: medicareresources.org

Best Medicare Supplement Insurance Quotes

Every Medicare supplemental insurance plan must follow federal and state laws designed to protect you. Medicare supplement plan insurance companies can only sell you a “modernized” Medicare supplemental insurance plan identified by letters A through N. Each modernized Medicare supplemental insurance plan must offer the same basic benefits, no matter which insurance company sells it.
Source: medicaresupplementplans.com

Florida Medicare Supplement Quotes

There are ten different Florida Medicare supplement plans.  Each of the plans will cover a different number and variety of the nine coverage gaps in Medicare Part A and Part B.  Florida Medicare supplemental insurance plan F will cover all the gaps.  Medicare supplement plan A and plan B will only cover four and five of the gaps respectively.  The more coverage you received from one of the plans the greater the monthly premium.  The plans are standardized so whether you get a Tampa Medicare supplement, a Miami Medicare supplement, or an Orlando Medicare supplement the coverage will be exactly the same.  This even applies across different companies.  So AARP offers the exact same coverage from plan G that Mutual of Omaha does.  You have to decide how much you are willing to spend per month versus how much coverage you want in order to pick the right Florida Medicare supplement insurance for your needs.  The only way to do this is with a set of Florida Medigap quotes.
Source: floridamedicaresupplementquotes.com

Medicare Sustainable Growth Rate

Posted by:  :  Category: Medicare

Section 101 of the Tax Relief and Health Care Act of 2006 (MIEA-TRHCA) provided a 1-year update of 0% for the conversion factor for CY 2007 and specified that the conversion factor for CY 2008 must be computed as if the 1-year update had never applied. Section 101 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) provided a 6-month increase of 0.5% in the CY 2008 conversion factor, from January 1, 2008, through June 30, 2008, and specified that the conversion factor for the remaining portion of 2008 and the conversion factors for CY 2009 and subsequent years must be computed as if the 6-month increase had never applied. Section 131 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) extended the increase in the CY 2008 conversion factor that was applicable for the first half of the year to the entire year, provided for a 1.1% increase to the CY 2009 conversion factor, and specified that the conversion factors for CY 2010 and subsequent years must be computed as if the increases had never applied.
Source: wikipedia.org

For 17th time in 11 years, Congress delays Medicare reimbursement cuts as Senate passes ‘doc fix’

“I’m pleased that we’ve been able to come to an agreement to vote today on a 12-month fix to the Medicare physician payment system. We need to take action on this to ensure that Medicare patients will be able to see their doctors,” Senate Majority Leader Harry Reid said Monday in a speech on the Senate floor. “But the fact remains that the agreement we have in place is not ideal … Regrettably, we just don’t have the votes right now to fix this problem for good.”
Source: washingtonpost.com

Doctors Face A 24% Pay Cut In Both Medicare And Medicaid Reimbursements

In whose judgment is it a better policy, yours or some superior being or at least one that thinks they are superior to others. The population of the country needs protection from the elitists that think they know better what is best for everyone else. Many of us started multiple company’s, manufacturing and otherwise, over our lives and somehow managed to make decisions as to what is best for us and our families. Many of us still feel we are capable of similar decisions regarding healthcare. Many of us believe the quality of healthcare received should not be reduced for the poor but should be similar to the quality we have received. We believe it can and should be accomplished. 38 States have high risk pools so those (mainly individual policy holders, most groups take on pre-existing conditions) with pre-existing conditions can be insured. The problem is cost and that can be remedied with subsidies at the State level. There is room for many approaches to be tried under what was our system. Unfortunately, a piece of garbage is being crammed down the throats of Americans. I might add the way it works out, is higher cost for most, not lower cost. The loss of coverage by Congressional Budget Office (CBO) estimates is expected to exceed 29,000,000 group plans (small groups require at least 3; normal groups more than 10). My understanding is in excess of 6,000,000 have received cancellations as of this date and the President’s putting off until after the election next year, the Small Business cancellations (minimum of 3 to constitute a small group) and the larger business insurance cancellations explain why there are fewer cancellations than would have occurred under the law, but they will occur and cause companies to have to alter their plans. We have a very innovative and imaginative population and limited problems as a country except those imposed on us from on high. People have an amazing ability to solve problems if you let them. They will normally due what is best for them.
Source: forbes.com

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More public reporting on hospital quality could help to reduce hospital prices, a new study suggests. According to the authors, the results may indicate that commercial health plans used hospital performance as leverage to negotiate prices where quality data became available for the first time.
Source: modernhealthcare.com

Small Slice of Doctors Account for Big Chunk of Medicare Costs

"We look forward to making this important, new information available so that consumers, Medicare and other payers can get the best value for their health-care dollar," said Jonathan Blum, principal deputy administrator for the Centers for Medicare and Medicaid Services, in announcing the effort. Under an agreement with CMS, The Wall Street Journal obtained the data early this week, but agreed not to contact physicians or share findings of its analysis with third parties until Wednesday.
Source: wsj.com