Help fight Medicare fraud

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Source: medicare.gov

Research, Statistics, Data & Systems

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Source: cms.gov

Medicare Fraud Strike Force

These teams have a proven record of success in analyzing data and investigative intelligence to quickly identify fraud and bring prosecutions. The interagency collaboration also enhances the effectiveness of the Strike Force model. For example, OIG refers credible allegations of fraud to the Centers for Medicare & Medicaid Services (CMS) so that it can suspend payments to the suspected perpetrators, thereby immediately preventing losses from claims submitted by Strike Force targets.
Source: hhs.gov

23 Stunning Medicaid Fraud Statistics

1. In May of 2014, some 107 healthcare providers including doctors and nurses were arrested in several cities. These ones were charged with cheating the programs out of some $452 million in funds. 2. In 2010 federal officials arrested some 94 people who had filed false claims through Medicare and Medicaid, for a total of $251 million in fraudulent claims. 3. The Medicare Fraud Strike Force was formed by federal officials in 2007. The group visited some 1600 businesses in Miami at random, following up on billing to Medicare for durable medical equipment. Of those businesses, nearly one-third did not exist although they had billed Medicare for $237 million in the past year. 4. It was reported to one source that Russian and Nigerian mobs had moved to Florida from New York because it was easier to become involved with Medicaid fraud than it was to be involved with other organized crime activities. 5. A former official in New York City stated that some 40% of Medicaid payments in that city were “questionable.” 6. A story by the New York Times reported that a dentist in Brooklyn had filed 991 claims to Medicaid in one day alone. 7. The five states with the highest number of fraud cases include California, Texas, New York, Ohio and Kentucky. 8. In 2011, state governments recovered some $1.7 billion from fraudulent payouts. They spent an estimated $208 million to accomplish this. 9. In that same year, the federal government also recovered some $4.1 billion from fraudulent activity, but they too needed to spend hundreds of millions of dollars to do this. 10. In 2010 the Government Accountability Office or GAO reported that they had found some $48 billion in “improper payments” during the past year for Medicaid and Medicare. This amount was roughly 10% of the $500 billion that was paid out during the year. 11. That same year, U.S. Attorney General Eric Holder suggested that the amount of fraud was actually higher, somewhere between $60 and $90 billion in payouts. 12. The Department of Health and Human Services currently uses what is often called a “pay and chase” model for finding Medicare and Medicaid fraud. This is the practice of routinely paying out every claim as it comes in and then only pursuing those that seem blatantly fraudulent, such as a dentist filing 991 claims in one day. 13. The Department’s Secretary Kathleen Sebelius has stated that they are planning on pursuing pre-claim adjudication to analyze patterns in claims before they are paid out, and are looking to abandon the “pay and chase” model within the next few years. 14. Some estimate that private insurers lose 1% to 1.5% of their revenue to fraud alone and credit card fraud is estimated to be at around 0.05%, while Medicaid and Medicare numbers are closer to 10% to 15%. One reason for this discrepancy is that private insurers and businesses like credit card providers may be more willing to invest in software and other technology that allows them to spot fraud much more quickly than government programs, and to do so before those claims and charges are paid. 15. Spending for healthcare is estimated to reach some $3 trillion in the U.S. in 2014 alone, although this amount does not currently keep up with the rate of inflation. 16. Claims pursued by the federal government in 2012 included unlawful pricing by drug manufacturers, illegal marketing of products and medical devices that have not been approved of by the Food and Drug Administration, and violations of law in regards to kickbacks and self-referrals. 17. The year 2012 marked the third year in a row that the federal government recovered over $2 billion in these types of health care matters. 18. In 2012 the Civil Division Consumer Protection Branch, which files civil suits against those convicted of Medicaid and Medicare fraud, obtained almost $1.5 billion in judgments, fines, and other forfeitures against those convicted of such frauds. The department also obtained 14 convictions under what is called the Federal Food, Drug and Cosmetic Act. 19. As a means of preventing such fraud, punishments have become more severe. In a case reported on in The Economist, one owner of a mental health clinic received a penalty of 30 years in jail for false billing. 20. The number of fraud cases that have increased the most over the past few years include home health visits, as these are difficult to track and to prove or disprove in court. Durable medical equipment is also a large portion of the fraud cases, including electric wheelchairs and walkers. 21. Overbilling for HIV infusion is also a popular scam, despite there being a much more affordable and effective way of treating the disease. When one such fraudulent ring was shut down in Florida, it resurfaced in Detroit and Medicaid and Medicare were again scammed out of thousands of dollars, by the same perpetrator. 22. Medicare processors handle some 4.5 million claims every single day, which is also a reason for the high volume of fraud. 23. Many fraud cases also involve stealing the identities of patients. This allows doctors and other healthcare professionals and those who have nonexistent medical storefronts to bill these programs for equipment and medications.
Source: healthresearchfunding.org

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

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Source: medicare.gov

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

About Medicare in New Mexico

I can help you compare the Medicare Advantage, Medicare Part D, and Medicare Supplement insurance plans available in your part of New Mexico. And who am I? Find out more about me by checking out my profile; just follow the View profile link below. I can speak with you by phone or send you information about plans by email; use the links below to tell me which way works better for you. If you’d like to learn more on your own, just click the “Compare Plans” button on this page. Or, if you’d like to speak with me or another licensed insurance agent right away, call us at 1-844-847-2659 (711 if you’re a TTY user) Monday through Friday, 8AM to 8PM ET, and we’ll gladly show you your options.
Source: medicare.com

New Mexico Medicare Health Insurance

We’re CDIS of New Mexico Inc., an independent, authorized exclusive general agent for Blue Cross and Blue Shield of New Mexico. Our knowledgable staff of seasoned Medicare experts has been helping New Mexico seniors get the most of Medicare for years and it won’t cost you a dime. We know medicare can be confusing, so if you have questions, we have answers. Whether you’re just browsing or ready to pick a plan that is right for you today, we’re here to help. Shoot us an email or give us a call. You’ll be glad you did.
Source: newmexicomedicarehealth.com

Medicare Advantage New Mexico

With an estimated 45 carriers offering Medicare Advantage in New Mexico, Molina Healthcare is the state’s leader, with 55,000 enrollees. Other carriers include: Coventry, MVP Health Plan, New West Health Services and Triple-S Advantage Inc. But all carriers may experience enrollment increases, due to Blue Cross Blue Shield of New Mexico’s planned removal of its individual Marketplace insurance products.
Source: medicare.net

NM Human Services Department

The Human Services Department invites you to participate in a public forum and provide meaningful comments about Medicaid’s Centennial Care program. The Department looks forward to receiving the public’s feedback about Centennial Care, nearing the end of its third year. Per its agreement with the federal government, the State may hold the public forum as part of its Medicaid Advisory Committee (MAC) meeting. The forum will take place at the next MAC meeting on Monday, November 14th, from 1-4 p.m. at the Garrey Carruthers State Library in Santa Fe (1209 Camino Carlos Rey, Santa Fe, NM 87505). Providers, members, advocacy groups and other parties interested in discussing the Centennial Care program are welcome to attend. We look forward to your participation. For more information, call 505-827-3101.
Source: nm.us

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

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Source: medicare.gov

Medicare Advantage Leads, Medicare Supplement Leads, Turning 65 Leads

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Medicare advantage leads (Medicare insurance leads) generating service with Sales Associate®, Texas based telemarketing firm is the right choice. We are producing Medicare leads prospects in the form of scheduled appointments and telemarketing leads. Company offers a streamline of Marketing services such as: Medicare Advantage leads, Medicare Supplement Leads, Special Need, Dual Eligible leads, Turning 65 Leads (Seniors 64 and 65 with Medicare Part A and Medicare Part B), Medicare leads list and other types of senior prospects.
Source: medicareadvantageleads.com

Medicare Supplement Leads and Medicare Advantage Leads

Over 65 Medicare Supplement leads cannot be overlooked. There are so many Americans paying more than they need to. They understand the process. They are NOT bombarded with mail. If you sell one of the top two lowest carriers in your market, this is a remarkable marketing tool.
Source: targetleads.com

Medicare Leads and Dual Eligible Leads from us

We have the experience to deliver quality exclusive Medicare leads for agents nationwide who are selling Dual Eligible, Medicare Special Needs, Turning 65 or Medicare Supplement plans all year round. The Medicare Dual Eligible market has become profitable for many insurance agents in the business. Dual Eligible Medicare leads are seniors who are over the age of 65 and have full Medicaid and Medicare. These prospects do not have enough income to keep up with their medical expenses. They are essentially rewarding for insurance agents who would like to move in the market of Medicare Dual Eligible prospects. We focus on these prospects to provide our agents exclusive qualified leads. We guarantee they are eligible and interested in meeting with an insurance agent specializing in Medicare plans. We also focus on a very lucrative market of Medicare Supplement and Turning 65. These leads are gold! Sales Associate® has been generating these exclusive leads for over 10 years. The baby-boomers are now reaching towards Medicare eligibility. Our appointments and phone leads are specifically filtered to your needs and delivered to you within 24 hours. Sales Associate® provides quality preset appointments and phone leads for agents targeting the Medicare market nationwide (excluding Alaska and Hawaii). We take away the stress of finding prospects to sell them your Medicare plans and give you the ability to increase your sales. Our skilled team qualifies each prospect by making sure they have Part A and B, no group or retirement benefits as well as no military insurance such as Tri-Care for Life. You can control your own geographic preference and income target. Grow your business throughout Annual Enrollment! We are here to help.
Source: us-leads.com

Medicare Leads for T65, Med Supps and Insurance Sales

We are committed to provide quality leads to Insurance agents. Our partnership enables the insurance agents to have high volume leads that provide them the prospective buyers who are actively searching in the market for health insurance plans. As the providers of the best quality leads we are committed to satisfy the insurance agents as well as the consumers. All the insurance agents who buy our leads experience more Medicare Advantage enrollments and Medicare supplements since they are able to get easily the prospective customers who are really interested to buy the particular insurance plans. As a result the consumers are able to get an immediate quote online from the agent. For the consumers, it will be a smooth, easy and quick process. By providing an easy, comfortable and reliable service we make the consumers to buy the insurance plans from the agent. Hence, the agents who buy the leads from us are assured of a higher close ratio. We provide them exclusive health insurance leads that enable them to expand their customer base rapidly.
Source: medicareleadsandpresetappointments.com

Anthem Medicare Insurance Plans

Posted by:  :  Category: Medicare

Medicare Advantage Plans offer approved Part C alternatives to the entire Original Medicare program that typically provide additional benefits. Plans offered by Anthem cover all your Medicare Part A and Part B benefits plus more, depending on your state and the particular plan you choose. Typical examples of added-value benefits are Anthems extensive preventive care coverage, wellness programs, and prescription drug benefits. These plans come in different formats, including Preferred Provider Organizations (PPOs), Regional PPOs, Health Maintenance Organizations (HMOs), and HMO Dual Eligible Special Need Plans (D-SNPs). They are predominantly branded as variations of the plan names MediBlue, Medicare Preferred, and Senior Advantage.
Source: medicaresolutions.com

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

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Source: medicare.gov

Anthem: Login to the site

Agents wishing to sell SNP plans must take both the SNP and Part D modules as part of their certification, as well as the HMO or PPO module, depending on the type of SNP plan available to market in their area. This product training is in addition to the required compliance training. Failure to complete all required product modules will result in a noncompliant and non-commissionable sale.
Source: cmpsystem.com

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

2017 Medicare Advantage Plans Available to Residents of Florida

AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY
Source: q1medicare.com

2017 Florida Medicare Supplement Insurance Plans

The key to finding the perfect plan is to have all of the information in front of you so you can compare plans. Keep in mind, there are significant differences between lettered plans and it makes sense to review everything to ensure you’re making the best choice. Some plans provide coverage if you travel outside the United States, others do not. At Secure Health Options, we can help you locate these options with Florida Blue so you can have all the information you need to make the right decision, easily and conveniently.
Source: myfloridamedicareplan.com

Florida Blue Medicare Advantage Plans for 2017

Are you a Florida senior citizen who is trying to maximize your Medicare benefits? Just as each senior citizen has her own unique needs and preferences, insurers offer a variety of different ways to enjoy these hard-earned health benefits and even help you plan for medical expenses that original Medicare does not completely cover. At Secure Health Options, we want to help all Floridians find the right plan that assures them of convenient and affordable access to the best medical providers. You can request information on 2017 Medicare Advantage plans and Florida Medicare supplemental insurance in your own local area by entering your home ZIP code in the box at the top of this page. If you have questions or would like help signing up, be sure to give us a call.
Source: floridamedicareadvantageplans.com

MyMedicare.gov: Customer Service

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Source: mymedicare.gov

Contact Information and Websites of Organizations for Medicare

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Source: medicare.gov

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

Medicare Generations Advantage Online Enrollment for 2016

You may download Adobe Reader free to read the enrollment form for a Generations Advantage Medicare plan. The materials on this page may be made available in other formats such as Braille, large print or other alternate formats. Please contact us for more information at 1-800-603-0652 (TTY:711). Hours are 8 am to 8 pm, seven days a week from October 1 – February 14, and 8 am to 8 pm, Monday through Friday after February 14. Calls to these numbers are free.
Source: martinspoint.org

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

Posted by:  :  Category: Medicare

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Source: medicare.gov

The Road Leading to Medicare – Planning the Trip

If you have an employer group health plan (EGHP) that will continue to pay secondary after you become eligible for Medicare, you’ll want to study the benefits booklet to learn about the cost and benefits of the plan, or speak with your employer’s benefits officer. Then determine if you should keep your EGHP as secondary to Medicare or if you need to drop it and purchase a Medicare supplement policy or join a Medicare Advantage plan. If your EGHP has drug benefits, make sure they are as good as or better than Medicare Part D Prescription Drug coverage.
Source: alabamamedicare.com