Should Medicare Benefits Be Taxed?

Posted by:  :  Category: Medicare

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Source: ncpa.org

Video: How to Save Medicare $30 billion: www.UpgradeThe Card.org

Trends in the Use and Cost of Chiropractic Spinal Manipulation Under Medicare Part B

RESULTS:   The number of Medicare beneficiaries who used chiropractic spinal manipulation grew 13% from 2002 to 2004, remained flat through 2007, and then declined 5% through 2008. An estimated 1.7 million beneficiaries (6.9%) used 18.6 million allowed chiropractic services in 2008. In inflation-adjusted dollars, allowed charges per user increased 4% through 2005 and then declined by 17% through 2008; payments per user increased by 5% from 2002 to 2005 and then declined by 18% through 2008. Expenditures for chiropractic in 2008 totaled an estimated $420 million. Longitudinal trends in allowed claims for spinal manipulation varied by procedure: the relative frequency of treatment of one to two spinal regions declined from 43% to 29% of services, treatment of three to four regions increased from 48% to 62% of services, and treatment of five regions remained flat at 9% of services.
Source: chiro.org

The other Washington could hold the key to Medicare's cost crisis

 But in Washington state, which is known for its progressive politics, the measure, requested by former Democratic Gov. Christine Gregoire, sailed through the legislature, albeit with an appeals process amendment the governor vetoed. “Medicare should be doing this, but it gets rolled by the Congress,” said Dr. Robert Berenson, a health policy expert at the Urban Institute and former commissioner of the Medicare Payment Advisory Commission (MEDPAC), an independent agency that advises Congress on issues affecting Medicare. Berenson pointed to several high-profile examples of Congress meddling with coverage policy, including the case of the late Sen. Ted Stevens of Alaska, who at the behest of the PET scan industry almost single-handedly forced Medicare to cover the scan as a test for Alzheimer’s, a policy that existing science did not support.
Source: publicintegrity.org

Today in labor history: Medicare and Medicaid established

Because protecting and improving Medicare is critical to health care cost containment, Republican proposals to pare back Medicare actually would increase overall health care costs. For example, the Republican budget proposal for FY 2012 would replace Medicare with vouchers to purchase private health coverage. According to the Congressional Budget Office, this proposal would result in total health care spending for an average 65-year-old that is nearly 40 percent higher than under the current Medicare program. Out-of-pocket costs for a typical senior would almost double. The result of this proposal would be to simply shift costs onto seniors, not to control costs.
Source: peoplesworld.org

Evidence Supports Medicare For All

The poor US performance on preventable mortality.  The United States ranks last out of 16 countries in deaths that might have been prevented with timely and effective medical care, leading to an estimated 91,000 excess deaths annually. In this context, Goldman and Leive’s claim that high U.S. health spending is buying more effective treatment of breast and prostate cancer compared to other countries is of questionable significance as well as accuracy. Earlier diagnosis from greater screening improves survival times for cancers, especially at five years, but has very little impact on mortality.  At any rate, Medicare for All would not reduce spending on cancer treatment. The whole point of single payer is to shift resources we are squandering on bureaucracy (including the administrative burden on physicians and hospitals) into clinical care, increasing the amount available to care for patients by about $380 billion annually, according to the authors of a landmark New England Journal of Medicine study.
Source: healthaffairs.org

Railroad Medicare is Part B Medicare for retirees

Posted by:  :  Category: Medicare

If a provider or supplier you want to work with participates in Medicare, but states “not Railroad Medicare,” Palmetto GBA recommends that they call Palmetto’s Provider Contact Center at (888) 355-9165. Palmetto’s staff is trained to discuss these matters with all Part B providers and suppliers. They also recommend providers or suppliers visit Palmetto’s website at www.PalmettoGBA.com/RR.
Source: utu.org

Video: Attained age vs Community rated Medigap policies

A Simple Primer on Medicare Benefits Written for Patients and YOU!

Strategist, Rehabilitation Management, MediServe a Mediware Company; Darlene is a PT with an MBA in Healthcare Management, in her role, as a Rehab Mgmt Strategist/Consultant she brings information to leadership that help guide practice strategy. Her focus is to assist clients nationally in the use of charting data to drive clinical and financial performance in support of decisions for best practices in meeting rehabilitation compliance, outcomes, revenue and efficiency. Since February 2011, Darlene has visited more than 30 IRF locations to assist in guiding C.O.R.E. (Compliance, Outcomes, Revenue, Efficiency/Effectiveness), performance improvement plans. Working in rehab medicine for greater than 30 years, Darlene spent 12 years in executive leadership as a Director of Rehabilitation and Operations. Therapy oversight included three post-acute service lines: acute inpatient rehabilitation (IRF), skilled and outpatient hospital-based services and is LEAN trained in healthcare. At various points in her career, Darlene had oversight of rehabilitation admissions, marketing, quality improvement, dietary & maintenance. Her responsibilities have included compliance toward Federal Regulations and leading CARF and Joint Commission standards of practice. Her experience includes Quality Improvement Chair, Lean Healthcare Trainer Certification and Vice President of the Board of Directors for the Ohio Association of Rehabilitation Facilities (OARF). Darlene lectures and writes blogs on post acute care topics that include federal guidelines, post acute admissions, managing outcomes, documentation, and rehabilitation marketing. www.mediserve.com/blog
Source: mediserve.com

Sightings Over Sixty: Tips for Enrolling in Medicare

. This part of Medicare is actually something separate. It is a Medicare Advantage plan. This is an insurance plan supplied by a private company that works directly with Medicare. The Medicare Advantage plan consolidates all your other Medicare options into one overall plan.      So, with a Medicare Supplement plan (which does not count as Part C), you pay separately for Part B, Part D, for the supplement plan itself, and for any other insurance you might want — like a dental insurance plan, for example.      With a Medicare Advantage plan, or Part C, you pay one bill that includes your drug plan, and also typically offers a dental plan. However, the Medical Advantage plan is either an HMO plan, or a PPO plan. With an HMO, you must go to a doctor in the insurance company’s network. With a PPO you also go to a doctor in network. You can go to a doctor that’s out-of-network, but the insurance will only cover a smaller portion of the bill that Medicare doesn’t pay — leaving you exposed to unknown and perhaps very high medical costs.      Advice: If you want the convenience of a Medicare Advantage plan, and you want to stay with your current medical practice, you should call your doctor’s office and make sure the doctor is in the network of that particular plan.      Personally, when I was signing up, I thought I’d choose a PPO plan. I’d go to my doctor on a regular basis. But then, if I needed some kind of specialist that was out-of-network, I could go, and I’d just have to pay more.      Then I found out that my current medical group does not accept the Medicare Advantage plan of my old insurance company, which was HIP. That would mean I’d be paying out-of-network fees every time I go to the doctor.      It didn’t make sense to me that my medical group would accept regular HIP; but not accept HIP Medical Advantage. But that’s the policy. And my medical group is the biggest, most comprehensive medical group in my area. I did not want to change.      Then I researched the AARP offering, through United Healthcare. My medical group accepts the United Healthcare Medicare Supplement plan. But, for some reason, it does not accept the United Healthcare Medicare Advantage Plan. Therefore, again, with the Advantage plan every time I’d go to the doctor, I’d be paying out-of-service fees.      So I chose the AARP United Healthcare Medicare Supplement Plan. I do not have my insurance wrapped up into one policy. I pay a separate bill each, for Medicare Part B, Medicare Part D, and the Medicare Supplement plan. And then, since my supplement plan does not include dental, I purchased a separate dental plan through AARP, with yet another bill, for another $40-some per month.      I pay four separate bills. The good news is that altogether they are about a third less than what I was paying through my old medical insurance plan, as of two months ago.      I have yet to actually use Medicare. I haven’t been to the doctor yet. I sure hope the process becomes a little easier.      Meantime, I know there are lots of people with more Medicare experience than I have. So if I’ve got anything wrong here, I hope you will correct me. Or if there’s anything to add, which could help the Medicare neophyte, I hope you won’t hesitate to append your advice. Thanks and good luck!
Source: blogspot.com

MLN updates education product, info series

MLN Guided Pathways (Basic, A, and B) Provider-Specific Resource Booklets (Revised) — The revised MLN Guided Pathways curriculum is designed to allow learners to easily identify and select resources on topics of interest. The curriculum begins with basic knowledge for all providers and then branches from information for either those enrolling on the 855B, I, and S forms or on the 855A form (or Internet-based PECOS equivalents) to a provider-specific resource booklet. The provider-specific booklet provides various specialties of health care professionals, (physicians, chiropractors, optometrists, podiatrists), nurses (APN, RNCNS, NP, Midwife) physician assistants, social workers, psychologists, therapists (OT, PT, SLP), dietitians, nutritionists, suppliers (ambulance, ASC, DMEPOS, FQHC, RHC, labs, mammography, radiation therapy, portable x-ray), and providers (CMHC, CORF, ESRD, HHA, hospice, OPT, pathology and SNF) with resources specific to their specialty including Internet-Only Manuals (IOMs), Medicare Learning Network publications, CMS web pages, and more.
Source: newsfromaoa.org

The Future of Medicare: 15 Proposals You Should Know About

Reader stories help us fine-tune our education efforts and strengthen our calls for action on issues that matter most to you. We read and learn from every story and may use yours (with permission) to brief legislators, inspire other readers and more. Please share your story with us. Do
Source: aarp.org

Centers for Medicare and Medicaid Release Mammography Booklet

In early March, the Centers for Medicare and Medicaid released the “Screening and Diagnostic Mammography” booklet in both a downloadable and hard copy format. This booklet is designed to provide education on early diagnosis and treatment of breast cancer. It includes information on screening mammography, diagnostic mammography, as well as other provider and beneficiary resources.
Source: ons.org

News from Medicare & Other Payers for the Week of January 23, 2012: 5010 National Provider Call This Week; Most Insurances Will Be Required to Cover Birth Control Without Co

In August 2011, the Department of Health and Human Services issued an interim final rule that will require most health insurance plans to cover preventive services for women including recommended contraceptive services without charging a co-pay, co-insurance or a deductible.  The rule allows certain non-profit religious employers that offer insurance to their employees the choice of whether or not to cover contraceptive services. Today the department is announcing that the final rule on preventive health services will ensure that women with health insurance coverage will have access to the full range of the Institute of Medicine’s recommended preventive services, including all FDA -approved forms of contraception.  Women will not have to forego these services because of expensive co-pays or deductibles, or because an insurance plan doesn’t include contraceptive services. This rule is consistent with the laws in a majority of states which already require contraception coverage in health plans, and includes the exemption in the interim final rule allowing certain religious organizations not to provide contraception coverage. Beginning August 1, 2012, most new and renewed health plans will be required to cover these services without cost sharing for women across the country.
Source: managemypractice.com

Download the CMS Medicare and You 2011 Handbook

The official U.S. government Centers for Medicare and Medicaid Services Medicare and You 2011 handbook is available for online viewing and downloading. The handbook is the standard Medicare reference book and contains important information about:
Source: elderguru.com

A guide for new and first

Posted by:  :  Category: Medicare

With a new class of medical residents beginning their training, and residents and Fellows graduating from their programs every July, it’s important that our critical partners in the delivery of healthcare have the tools they need to understand federal program requirements.  At the Centers for Medicare & Medicaid Services (CMS) we have a comprehensive strategy to reduce fraud, waste and abuse that is designed to target risk – that means as we make it harder for bad actors to enroll or bill in our systems, we are always evaluating how to make it easier for legitimate physicians and other providers to participate in Medicare and care for beneficiaries.
Source: cms.gov

Video: CMS MEDICARE AND PECOS PROVIDER ENROLLMENT .wmv

Medicare Open Enrollment Period Begins Oct. 15, 2013

Medicare recipients reaching the drug donut hole will benefit from lower costs. The gap in prescription drug coverage starts when someone reaches the initial coverage limit, estimated at $2,850 in 2014. It ends when they have spent $4,550, when catastrophic coverage begins. (These are reductions of $120 and $200, respectively, from 2013.) During the donut hole, all costs are covered by individuals out of their own pocket. In 2014, those who reach the donut hole can receive a 52.5 percent discount on brand-name drugs and 28 percent discount on generic drugs (an increase from 21 percent in 2013).
Source: disabled-world.com

Medicare and Reform: 50 States of Confusion

Closes the Coverage Gap: The Coverage Gap — also known as the donut-hole — is the portion of a Part D plan where beneficiaries pay a higher portion of their medication costs until they reach a certain dollar amount, known as an out-of-pocket maximum. Since 2010, with the help of pharmaceutical manufacturers, CMS has lowered the copayment amounts on brands and generics. Since this change began in 2010, beneficiaries have saved $1,000, on average. By 2020, the Coverage Gap will go away completely. Surprisingly, 77% do not know that the Coverage Gap is in the process of closing due to reform and are unaware of the current savings.
Source: express-scripts.com

What is the Difference Between Original Medicare and Medicare Part D?

Another way to get Part D coverage is by enrolling in a Medicare Advantage Prescription Drug (MAPD) plan that combine prescription drug coverage with hospital and medical insurance. However, if a beneficiary chooses to enroll in a Medicare Advantage (MA) plan that does not offer prescription coverage, they may not be able to join a stand-alone Part D plan for medication coverage. The only types of MA only plans that allow a beneficiary to also enroll in a PDP include: Private-Fee-For-Service (PFFS), Medical Savings Account (MSA), or Cost plan. If an MA plan without drug coverage does not allow enrollment in a PDP, beneficiaries should consider looking into switching into an MAPD during the next Medicare Annual Enrollment Period (AEP).
Source: ehealthmedicare.com

CMS Stops Provider Enrollment With First

Since March of 2011, CMS has revoked the ability of 14,663 providers to bill in the Medicare program. According to a story in Senior Housing News, the agency is now flexing more of its regulatory muscle by enforcing its first-ever moratorium on new provider enrollment in the Medicare program. The moratorium does not affect existing providers and suppliers, who can continue to bill Medicare for services. However, in select areas, no new provider or supplier can begin billing Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) until the moratorium is lifted.
Source: healthcaretechnologyonline.com

CMS Announces Medicare Providers Must Begin to Revalidate Enrollment By March 2013

In the continued effort to reduce fraud, waste, and abuse, CMS implemented new screening criteria to the Medicare provider/supplier enrollment process beginning in March 2011.  Newly-enrolling and revalidating providers and suppliers are placed in one of three screening categories – limited, moderate, or high – each representing the level of risk to the Medicare program for the particular category of provider/supplier, and determining the degree of screening to be performed by the Medicare Administrative Contractor (MAC) processing the enrollment application. More information on the screening categories is here.
Source: managemypractice.com

U.S. Bans New Home Health, Ambulance Providers In Three High

Fiscal Times: Abuse And Neglect In Assisted Living Facilities You’ve seen the sales pitches about America’s assisted living facilities. Seniors can flourish in bright, cheery alternatives to nursing homes and live out their golden years securely, monitored by medical professionals who tend to their every need. The business of assisted living paints a depressingly different picture, according to a provocative new documentary from PBS Frontline airing this Tuesday night, accompanied by a series from ProPublica that is being published this week. Nearly 750,000 American seniors live in assisted living facilities today — but instead of being cared for, many are abused and neglected, according to a year-long investigation (Mackey, 7/29).
Source: kaiserhealthnews.org

CMS Proposes To Further Tighten Medicare Provider Enrollment Rules

Ms. Stamer has extensive experience advising and assisting health care providers and other health industry clients to establish and administer compliance and risk management policies and to respond to DEA and other health care industry investigation, enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. A popular lecturer and widely published author on health industry concerns, Ms. Stamer continuously advises health industry clients about compliance and internal controls, workforce and medical staff performance, quality, governance, reimbursement, and other risk management and operational matters. Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns including a number of programs and publications on OCR Civil Rights rules and enforcement actions. Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.  You can get more information about her health industry experience here. If you need assistance with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 
Source: wordpress.com

Proposed Rule Would Reward Medicare Fraud Tipsters up to $9.9 Million, Revise Medicare Provider Enrollment Regulations : Life Sciences Legal Update

In the proposed Medicare Incentive Reward Program rule, CMS explains that it “tentatively project[s] a net increase in recoveries of $24.5 million per year as a result of the proposed changes.”  In addition, CMS notes that it is modeling the proposed Incentive Reward Program changes on a “highly successful” Internal Revenue Services (IRS) reward program that returned “far greater sums than the existing Medicare [Incentive Reward Program].”  Notably, since the implementation of the current Medicare Incentive Reward Program in July 1998, CMS has collected only $3.5 million; in contrast, between 2007 and 2012, the IRS has collected almost $1.6 billion through its reward program.  CMS states in the preamble that it proposes to clarify that it will not pay an award if the same or substantially similar information was the basis for a relators share in a qui tam lawsuit under the federal False Claims Act or a state False Claims Act, or is the basis for a pending state or federal False Claims Act suit.  However, the proposed regulatory language that would codify this change, found at proposed 42 C.F.R. § 420.405(b)(3), does not specify that this provision would apply to state False Claims Acts.
Source: lifescienceslegalupdate.com

Medicare Cuts, Obamacare Prompt Hospital Layoffs

Posted by:  :  Category: Medicare

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“The sheer magnitude of the Medicare and Medicaid cuts impel us to look at all of our services and costs, including the largest component of our budget—personnel,” Cummings said, citing a 20 percent cut in Medicaid proposed by Democratic Gov. Dannel Malloy and approved by the state legislature resulting in a $550 million hit to Connecticut hospitals. Sequestration also resulted in an additional $1 million loss for L + M this year.
Source: freebeacon.com

Video: New York and Medicare Supplements

ALBANY, N.Y.: Rochester, NY, cited for lowest Medicare spending

Rochester’s success at holding down costs provides a model that Gov. Andrew Cuomo’s administration wants to take statewide. Essentially, a standing regional advisory committee made up of various health care stakeholders reviews the need for new departments, new staffing and expensive pieces of equipment and recommends against those that aren’t needed in the community.
Source: heraldonline.com

HAPPY 48TH BIRTHDAY MEDICARE : Single Payer New York

Yet, many in Congress want to privatize Medicare (along with Social Security and Medicaid), to benefit the for-profit health insurance industry at the expense of millions of Americans. Just say NO!    Extending Medicare for all would save more than enough to eliminate all cost sharing such as copays and deductibles, guarantee comprehensive coverage for all, and be there for future generations.
Source: singlepayernewyork.org

Free “Health Insurance” Workshops to Educate New Yorkers

The New York City Health and Hospitals Corporation (HHC) is a $6.7 billion integrated healthcare delivery system with its own 420,000 member health plan, MetroPlus, and is the largest municipal healthcare organization in the country. HHC serves 1.4 million New Yorkers every year and more than 475,000 are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. HHC Health and Home Care also provides in-home services for New Yorkers. HHC was the 2008 recipient of the National Quality Forum and The Joint Commission’s John M. Eisenberg Award for Innovation in Patient Safety and Quality. For more information, visit www.nyc.gov/hhc or find us on facebook.com/nycHHC or twitter.com/HHCnyc.
Source: nyc.gov

Colorado’s Medicare Q.I.O. Featured In New York Times Article

Asked what she would like the elderly and their caregivers to know about Q.I.O.’s, or Medicare quality improvement organizations, Nancy Borgstadt, director of review services for CFMC, the Q.I.O in Colorado, tells The New York Times, “We are here to listen to them and give them a voice.”
Source: coloradohospice.org

NY Times Prints Apples vs. Oranges Study on Medicare Costs and Income

The problems with the latest study are identical with those in the comparable “study” issued by the Social Security Administration through the office of Sen. Marco Rubio (R-Fla.). That document showed that if you take a snapshot of the situation you will find that immigrants pay more into the Social Security Trust Fund than they take out, as discussed in this CIS report. The SSA’s tabulations did not touch on the life-long balance of Social Security costs of natives and immigrants, just the short-term balances, which are heavily influenced by the relative youth of the adult migrants.
Source: cis.org

Medicare Physician Payments: Reforming the Sustainable Growth Rate

Posted by:  :  Category: Medicare

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The language in the House discussion draft—linking Medicare physician pay to compliance with government-established guidelines—accelerates a troubling trend reinforced by Obamacare itself. The national health care law, with 165 provisions affecting Medicare,[23] not only retains the SGR, but, like the SGR, it also imposes a hard cap on the growth of all Medicare spending. It creates an Independent Payment Advisory Board (IPAB), which will have the power to enforce the cap, and recommend even more Medicare reimbursement cuts for physicians and other medical professionals. It creates new institutions to change Medicare payment and delivery through administrative action, such as the Center for Medicare and Medicaid Innovation, with demonstration programs designed to end traditional fee-for-service (FFS) payments. Beyond these new institutions, the health law creates new Medicare “quality” programs and extends the Physician Quality Reporting Initiative (PQRI), which will enforce new bonus and penalty payments for physician compliance. As the Congressional Research Service (CRS) reported in its first evaluation of the statute, the new law “makes several changes to the Medicare program that have the potential to affect physicians and how they practice in ways both small and large, immediately and over time.”[24]
Source: heritage.org

Video: Rep. Gingrey Discusses Medicare Reimbursement Rates

Medicare Reimbursement Increases Will Help Skilled Nursing Facilities

The issue of staffing is also connected to the issue of Medicare reimbursements that SNFs receive from the federal government. SNFs have great difficulty being able to pay staff that provides patient care if there is a reduction in Medicaid reimbursements. In general, about 80% of a SNF’s annual budget may be allocated to employee wages and benefits. SNFs that face Medicare reimbursement cuts also have to deal with increases in costs, and may lose staff as employees look for more competitive job opportunities. For a SNF, using Medicare reimbursement payments to help stay competitive with wages and benefits is a very important way of attracting quality staff.
Source: cambridgecap.com

Legal Solutions Blog | Blog | The Obamacare Report (#10)/Financial pressures change medical practices

Ferd H. Mitchell’s university faculty career includes teaching, researching and publishing in technical, management and health care disciplines. He has served as an academic administrator for a medical school, where he was director of a master’s degree program, and as vice-president of a company operating a contracted-out Medicaid program. He has performed numerous health care studies for federal and state governments. Ferd received a fellowship from the Japan Foundation to present a series of lectures in Japan on the U.S. health care system. He also participated, as the only U.S. representative, in a European study group developing new approaches to meeting the health care needs of the elderly.
Source: westlawinsider.com

Aetna to cut pathology reimbursement to 45

In 2011, Medicare paid between 18 and 30 percent more than other insurers for 20 high-volume and/or high-expenditure lab tests. Medicare could have saved $910 million, or 38 percent, on these lab tests if it had paid providers at the lowest established rate in each geographic area. State Medicaid programs and 83 percent of FEHB plans use the Medicare CLFS as a basis for establishing their own fee schedules and payment rates, although most pay less. However, unlike Medicare, FEHB programs incorporate factors such as competitor information, changes in technology used in performing lab tests, and provider requests in their payment rates. Some State Medicaid programs and FEHB plans required copayments for lab tests, which, in effect, lowered the costs of lab tests for the insurer.
Source: pathologyblawg.com

Doctors Refuse To Accept Medicare Patients

California Healthline says that physicians have several reasons for opting out of the program. Most significant, though, are the low reimbursement rates, concerns about patient privacy, and unhappiness with the government’s increasing involvement in medicine. As far as the increased government presence goes, Becker’s Hospital Review cites the penalties for physicians who do not demonstrate Meaningful Use through EHRs as an example. The WSJ also says that doctors recognize that Medicare payment rates have not kept up with inflation, and that there are dangers of more cuts in the future.
Source: healthcaretechnologyonline.com

Lobbying Congress for Medicare Reimbursement

This week, the full Energy and Commerce Committee, of which Walden is a ranking member, will consider new legislation that would provide stable payments for the first two years with annual increases after that. The legislation would phase in a new system that would remove some of the incentives for fraud and reward providers who offer quality care for less, Malcolm said.
Source: thelundreport.org

Medicare Plans vs Health Exchanges

Posted by:  :  Category: Medicare

About Express Scripts Express Scripts manages more than a billion prescriptions each year for tens of millions of patients. On behalf of our clients — employers, health plans, unions and government health programs — we make the use of prescription drugs safer and more affordable. Express Scripts uniquely combines three capabilities — behavioral sciences, clinical specialization and actionable data — to create Health Decision Science℠, our innovative approach to help individuals make the best drug choices, pharmacy choices and health choices. Better decisions mean healthier outcomes.
Source: bloomerboomer.com

Video: Debunking the “Raise the Medicare Eligibility Age” Argument

Extending Social Security and Medicare Eligibility Ages

In light of the increase in life expectancy after age 65 and the decline in physically demanding jobs, it would be reasonable for the eligibility age for social security to rise to 68 or 70. The average age of retirement from the labor force for Japanese males is already only a little below 70, which shows that much higher retirement ages is feasible. Persons who are physically or mentally incapable of working would then opt for disability status. This is a rapidly growing category in most developed countries, despite the increase in physical and mental health of older persons, because of a weakening of qualifying standards. With more flexible labor markets for the elderly, such as reducing the fear of companies that they will be sued for discrimination against older workers, older men and women could retire from more demanding jobs, and take jobs that are less taxing. This is what happens to older men in Japan.
Source: becker-posner-blog.com

Medicare and Reform: 50 States of Confusion

Closes the Coverage Gap: The Coverage Gap — also known as the donut-hole — is the portion of a Part D plan where beneficiaries pay a higher portion of their medication costs until they reach a certain dollar amount, known as an out-of-pocket maximum. Since 2010, with the help of pharmaceutical manufacturers, CMS has lowered the copayment amounts on brands and generics. Since this change began in 2010, beneficiaries have saved $1,000, on average. By 2020, the Coverage Gap will go away completely. Surprisingly, 77% do not know that the Coverage Gap is in the process of closing due to reform and are unaware of the current savings.
Source: express-scripts.com

Taking Medicare’s eligibility age off the table

CARNEY: Again, as part of a big deal, part of a comprehensive package that reduces our deficit and achieves that $4-trillion goal that was set out by so many people in and outside of government a number of years ago, he would consider that the hard choice that includes the so-called chain CPI, in fact, he put that on the table in his proposal, but not in a cherry-picked or piecemeal way. That’s got to be part of a comprehensive package that asks that the burden be shared; that we don’t, as some in Congress want, ask seniors to bear the burden of further deficit reduction alone, or middle-class families who are struggling to send their kids to college, or parents of children who are disabled who rely on programs to help them get through.
Source: msnbc.com

The Bonddad Blog: A thought for Sunday: the best jobs program = allow Medicare eligibility at age 55

- by New Deal democrat Regular economic blogging will resume tomorrow (and I know, because the post is already cued up). In the meantime, consider the following thoughts over my Sunday morning coffee, which hopefully aren’t too incoherent…. One of the many ranting points I see on progressive blogs is against “the top 20%” who are apparently presumed to be the functional equivalent of Jamie Dimon. Not so. Many of “the top 20%,” in terms of wealth as opposed to income, are also known as “mom and dad.” If you look at the Census Bureau’s breakdown of average wealth by age group, the most prosperous are those on the verge of retirement. They’ve had 30 or 40 years to gradually build up savings. For example, a couple who each have $50,000 jobs (in today’s dollars) and live frugally by spending half of their net earnings and saving the other half (roughly giving them $30,000 savings per year) will become millionaires in about 25 years (thanks to compounding and return on investments). Obviously this isn’t the majority – the median wealth of people in the 55 – 64 cohort is something like $200,000 – but a non-trivial percentage of middle class workers ultimately reach this milestone. And you know what they would like to do more than anythings else? Retire! I know this not only from personal conversations with my fellow fossils, but also through a discussion with an accountant recently in which he told me that the number one reason most of his older clients haven’t retired yet is because they are afraid to before they are eligible for Medicare. Or they have to continue to work after age 65 themselves because they need their health insurance to cover their spouse until their spouse reaches age 65. Meanwhile, people like David Leonhardt in the New York Times are writing about Today’s Idled Youth,” describing how the ongoing Hard Times have hit the young perhaps harder than any other group. They bought into the American Dream of studying for a degree, becoming a professional of some sort, and hoping for a decent middle class existence. Instead, they are taking clerical or entry level service jobs, or even worse, unable to find a job. You can see where I’m going with this now, right? Here we have the older workers, hobbling to the finish line, but unable to end the race. And here we have young workers, itching to get started, and they can’t because there are no jobs, or no middle class jobs, for them. And the one thing that would cause the many older workers who have saved for retirement to be able to leave the workfoce, and clear the way for those frustrated younger workers, is guaranteed medical care. Fortunately, we have a program that provides exactly that: it’s called Medicare, and according to those already on it, it works really really well. And it works at much lower administrative costs than for-profit private coverage (If I recall correctly, Medicare’s administrative costs are something like 3%, vs. 15% for for-profit plans)(UPDATE: According to the CBO, Medicare’s administrative costs are 2%, vs. 17% for for-profit plans. And Medicare premiums have consistently risen less than private health insurer premiums) . And also unlike for-profit plans, in Medicare there’s no incentive to deny coverage. As in, yes you can buy into a private plan at age 60 for example, but it will be very expensive and you’d better pray they don’t come up with an exclusion if a disease of age catches up with you. Atrios has written a number of times about increasing Social Security payments. Balderdash, say I. If you really and truly want to make a dent in the persistent employment problem facing younger workers, allow anyone age 55 or above to buy into Medicare. Charge them annual premiums equal to what they would have to pay into Medicare at their same wage or salary until age 65 if they continued to work. You would be amazed to see how quickly Boomers can still move, cleaning out their offices and cubicles, when properly motivated. And then younger workers could move right in. It’ll never happen, of course, because it smacks of the New Deal, not the “21st Century” privatized solutions Barack Obama has touted since 2009. And of course the GOP will never allow it, not just because it smacks of the New Deal, but because if Obama came out in favor of it, they would oppose it for the simple reason of opposing everything Obama wants. But that doesn’t mean we shouldn’t acknowledge that it is a real solution to a real problem, and collectively rub Washington’s Very Serious People’s noses in it.
Source: blogspot.com

Should Medicare’s Eligibility Age Be Raised?

I just signed up for Medicare and for Parts A, B, B supplemental and Part D, I will pay double than I paid during employment. That does not include all my out of pockets costs for copays and deductibles. This is on top of all the payments I made in my 45 working years. I am 66. I paid way more into SS than I will get out, assuming I had saved that money in T Bills. This is not entitlement. However, I do not think my doctors deserve that high fees they charge, and think there is over testing. I would like to see the implementation end of medicine improved, with doctors on salary, not fee for service. I would like testing to be based on actual need.
Source: wsj.com

What Raising the Medicare Eligibility Age Means

Raising the eligibility age saves very little money, on the order of a few billion dollars a year. That’s because the 65 and 66-year-olds will have to get insurance somewhere, and many of them are going to get it with the help of the federal government, either through Medicaid or through the insurance exchanges, where they’ll be eligible for subsidies. However, since many Republican-run states are refusing to expand Medicaid in accordance with the Affordable Care Act, lots of seniors who live in those states will just end up uninsured, which will end up leading to plenty of financial misery and more than a few premature deaths. Put this all together, and the Center on Budget and Policy Priorities estimates that while the federal government would save $5.7 billion a year from raising the eligibility age, costs would increase by more than twice in other parts of the system—for the seniors themselves, employers, other enrollees in exchanges who would pay higher premiums, and state governments.
Source: prospect.org

Brad DeLong : Raising the Medicare Eligibility Age Is a Really Bad Idea Blogging: Is This a Problem with the Media or with the Congressional Budget Office?

Director’s Blog: Raising the Ages of Eligibility for Medicare and Social Security: If the eligibility age was raised above 65, fewer people would be eligible for Medicare, and outlays for the program would decline relative to those projected under current law. CBO expects that most people affected by the change would obtain health insurance from other sources, primarily employers or other government programs, although some would have no health insurance. Federal spending on those other programs would increase, partially offsetting the Medicare savings. Many of the people who would otherwise have enrolled in Medicare would face higher premiums for health insurance, higher out-of-pocket costs for health care, or both.
Source: typepad.com

Survey: Seniors Confused About PPACA Exchanges, Medicare

The national survey of Americans aged 65 and older found one in five believe they can enroll in a medical or prescription drug insurance plan through the exchanges, even though those older than 65 aren’t eligible. Additionally, 29 percent falsely believe the healthcare reform law raises the Medicare eligibility age, and 17 percent believe the health plans sold through the exchanges could replace their Medicare coverage completely, according to the survey. Only 46 percent said they felt knowledgeable about reform.
Source: beckershospitalreview.com

Fight the Flu Program at Southcreek Office Park

Posted by:  :  Category: Medicare

Healthy Solutions, Inc. will be at Southcreek Office Park this fall offering flu shots so that you can protect yourself, your family, and your co-workers from illness!  Be sure to sign up for your vaccination soon!  Here is some more information about getting your vaccination:
Source: southcreekofficepark.com

Video: Medicare Basic Overview by United Healthcare Medicare Solutions

Medicare Survey of Boomers and Seniors

If you are interested in learning about how to find the best prices Medicare Supplemental insurance please check out our website at www.centaurmedicaresolutions.com  It is safe to get your Medigap quotes from us as we do not sell your information out to a bunch of agents like many website do these days.  Your information goes to only one agent to pull quotes!
Source: centaurmedicaresolutions.com

United Healthcare Acknowledges Payment Shortcomings : AAFP Leader Voices

Honestly, Dr. Cain, does United think we’ll swallow this load of hooey? They ask us to believe that: “United’s leaders” had no idea that for over two decades they’ve been forcing take-it-or-leave-it sub-Medicare contracts on family physicians (“Gambling in Casablanca? I’m shocked”); that, with all the resources of the country’s largest insurer, they’ve been unable during the past 14 months to identify physicians with those contracts; that they’re “developing solutions” while doing absolutely nothing; and that, icing on the cake, they “recognize the value of primary care” but, in the linked article say they will pay “incentive payments and fees GROWING (my caps) to a range of $0.45 to $3.30 PMPM” for medical home services. Dr. Cain, these are not decent, honorable people. They are con men: their words are lies, and their actions show nothing but contempt for the AAFP and family physicians. Every year, we read of these meetings, and every year things get worse. This approach does not work. Let me repeat: this approach DOES NOT WORK. The AAFP must take a strong adversarial approach if it wants to adaquately represent its members. A couple of suggestions: a major publicity campaign aimed at patients and employers outlining the actions/inactions of United and other insurers; a hot-line so physicians with these contracts can identify themselves, with the AAFP forwarding this information to United (along with the suggestion that, since their “leaders” didn’t know about these contracts, they re-process all claims from the last 10 years!); a blog in which physicians can report their experiences in renegociating their contracts; and, most importantly, the AAFP must walk out of the PCPCC, with a simple, public statement that we can no longer work in any capacity with organizations that are so hostile to our members and so damaging to our speciality. No family physicians, no medical home: this would carry some weight! We must refuse to allow our good name and reputation to be used as cover by these groups. The AAFP HAS to draw a line beyond which they will no longer tolerate this abuse of their membership. Thank you.
Source: aafp.org

United Healthcare Medicare Solutions

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Source: yourhealthwellness.org

Medicare Explained In Enfield

It will also look at ConnPace and the Medicare Savings Program, which provide those who qualify with additional financial assistance to cover prescription drugs and Part B premiums. Nancy Petronio, of United Healthcare Medicare Solutions, will present the overview and will also be available for questions.
Source: courant.com

Healthcare.Provider.Service: United Healthcare Medicare Solutions Provider Listing

acs global leader bpo provides healthcare services outsourcing help organization improve performance enhance care delivery healthcare provider services convergence global research network cgrn links patient data participating healthcare institutions pharmaceutical 2009 securehorizons aarp medicare plans evercare provider education kit player 2010 unitedhealthcare medicare solutions physician &amp provider information provider relationships place following insurance plans united healthcare wi medicare complete united healthcare wi labor employment area areas report highlights Black alternatives existing binding arbitration policy municipalities dod issues final rule mandatory arbitration restrictions defense contracts enforcing mandatory pre-dispute agreements arbitrate claim title
Source: gdf-jorge-antunes.com

ACA Medicare Payroll Tax Costs MA $1.7B Over 10 Years; 3 Patriots to Pay $707,850 in 2013

Posted by:  :  Category: Medicare

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Pioneer has long held that the healthcare policy conversation in the Commonwealth lacks an informed review of the financial consequences of each provision of the ACA. This brief is part of an ongoing series from Pioneer Institute examining the impact on Massachusetts taxpayers and employers. Recent publications include: “First Do No Harm ‘The Impact of the Affordable Healthcare Act on Massachusetts’ Medical Device Industry,’” April 2013, and “Impact of the Federal Health Law’s ‘Cadillac Insurance Tax’ in Massachusetts,” October 2012. In 2012, Pioneer published a timely book, The Great Experiment: the States, the Feds, and Your Healthcare.
Source: pioneerinstitute.org

Video: Medicare Investment Income Tax

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

Ask The Experts: Retirement

Q. I turned 65 and applied for Medicare Part A and B, which is in effect. I pay my Part B monthly premiums separately. I am still employed and noted the Medicare tax is still being deducted from my paycheck. Is this a standard deduction that should be reimbursed, or will this deduction remain in effect until I retire?
Source: federaltimes.com

MailBag: 0.9% Medicare Tax Withholding From Nonqualified Deferred Compensation And Separating Twitter Accounts For Personal And Business Use

Here’s an example of why it matters. I know that your firm’s account often shares and retweets some of the content I produce on Nerd’s Eye View, yet the reality is that much of the content I write is actually written for advisors, not clients. Consequently, it may feel relevant and interesting for you, personally (I hope!), but frankly it’s not really the kind of content you want/need to share from your firm’s account to your firm’s clients and prospects. Your clients don’t need to hear about the latest news from about the CFP certification’s progress towards the fiduciary standard, or why I think financial planners should have a Google+ page. Your clients needs to hear about what your firm has to share that’s relevant to THEM, not what’s relevant to YOU (at least, unless your target clientele really are people just like you!). That’s where having both a firm and a personal account matters; your firm can share and engage with what’s relevant to your target audience, and your personal account can share and engage with what’s relevant to you, personally.
Source: kitces.com

Understand and Plan for the New Medicare Tax

There has been a lot of confusion about the Medicare Tax and when it will apply. To put it simply, the tax applies to the smaller amount of a taxpayer’s net investment income or their modified adjusted gross income (MAGI) over the threshold. The threshold for single taxpayers is $200,000 and $250,000 for married taxpayers filing jointly. MAGI is the number on line 22 of the 2012 IRS form 1040. Distributions from qualified retirement accounts are not subject to the tax but the taxable income from non-qualified deferred annuities is considered investment income and subject to the tax. Other taxable investment income is – passive rental income, royalties, other passive activity income. Income excluded from the tax are – wages, municipal bond interest, life insurance proceeds, social security & veterans benefits, sale of a principal residence and income from an active interest in a business.
Source: rodgers-associates.com

3.8% Medicare Tax on Net Investment Income

What is net investment income for purposes of Section 1411? The statute and the recently released Treasury Regulations relating to Section 1411 provide that net investment income is the sum of three “categories” or “buckets,” less properly allocable deductions. Included with the first category is gross income from interest, dividends, annuities, royalties and rents (unless earned in the course of an active trade or business); included within the second category is other gross income from passive activities and trading in financial instruments or commodities; and included within the third category is the net gain from the disposition of property, including property held for use in passive activities and trades or businesses of trading in financial instruments or commodities. Importantly, the statute does not include the following in the calculation of net investment income:  wages, unemployment compensation, operating income from a non-passive business, social security benefits, tax-exempt interest, self-employment income and distributions from qualified retirement plans, such as 401(k)s and IRAs. However, because of the dual tax basis calculation required by the statute, the inclusion of these items in a taxpayer’s MAGI can result in the application of the 3.8% tax to other items of income that may have otherwise avoided the imposition of the new tax.
Source: jdsupra.com

Payroll Tax Loophole Used by John Edwards and Newt Gingrich Remains Unaddressed by Congress

Some lawmakers have proposed a more limited solution that is overly complicated but which would at least solve part of the problem. Such legislation was first introduced as part of a tax “extenders” bill in 2010 (in order to offset some of the cost of those tax breaks) and a version has been introduced this year by Congressman Charlie Rangel. This legislation would address situations in which an S corporation provides a service and generates most of its profits based on the reputation or skills of three or fewer people. If this rule had been in place, Edwards and Gingrich probably would not have been able to avoid their Medicare taxes. But it might have left the courts to deal with cases like McAlary’s (because his business arguably relied on the skills and reputation of more than three people). 
Source: ctj.org

NET INVESTMENT INCOME TAX (NIIT) AND THE ADDITIONAL MEDICARE TAX

The Treasury Department and Internal Revenue Service implemented two new taxes that were effective on January 1, 2013, the Net Investment Income Tax (NIIT) and Additional Medicare Tax. The NIIT is a 3.8% tax for individuals, estates, and trusts on certain investment income including, but not limited to, interest, dividends, capital gains, rental and royalty income, and businesses that are passive activities. Individuals are subject to the NIIT tax if they have net investment income and also have modified adjusted income in excess of the following threshold amounts:
Source: mencpa.com

Update on the 3.8% Medicare Tax

Unfortunately, the form was released without instructions. So no one is really sure how the tax is applied in some circumstances involving pass thru entities, rental real estate, and gains and losses from certain property dispositions.
Source: duganlopatka.com

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September 21, 2013

Anthem High Deductible F Supplement

Posted by:  :  Category: Medicare

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AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medicare Supplement AARP Medicare Supplements AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem Medicare Anthem Medigap Crowe and associates how to choose a Medicare Advantage plan How to choose a Medicare plan how to choose a plan How to choose a supplement how to enroll in a medicare plan MAPD Med Advantage Medicare Medicare A Medicare A and B Medicare Advantage MEdicare Advantage Connecticut Medicare Advantage plans medicare b Medicare Complete Medicare part B Medicare part B cost Medicare plan Medicare Supplement Medicare Supplement Connecticut Medigap Medigap connecticut Medigap rates 2013 Medigap rates NY 2013 Original Medicare sign up for medicare United medicare complete United Medicare complete 2013 Wellcare medicare
Source: croweandassociates.com

Video: Plan F Medicare Supplements

Medicare Supplemental Insurance Aarp Plan F Select Is A Particular Option

Can be however, advised how the person going to acquire a medigap plan f deal should study the sale documents of all the Medigap plans be cautious a decision. All the twelve Medigap policies lid the basic benefits, but each an individual has some additional solutions along with these products. In brief it can be mentioned that the Plan A trustworthy is the easiest plan. However the Plans B-L provides all the primary advantages of Plan A and along with they will provide some free coverage. Each Plans K-L offers the benefits further to Plans A-J, but the divergence is the cost-sharing for the relatively easy benefits which is special at different levels.
Source: gilevans.org

Medicare Drug Plan Polls Suggest Bright Future for Obamacare

Looking back on it, the public’s turnaround from initial rejection to growing support for Part D was understandable. The unfunded $400 billion program that President Bush signed into law in December 2003 was needlessly complex for seniors and unnecessarily expensive for taxpayers. Rather than having the government negotiate prices directly with pharmaceutical firms and add drug coverage into the traditional Medicare program, President Bush and his Republican allies in Congress instead gave recipients subsidies to purchase plans from private insurers. Making matters worse, millions of “dual eligible” already receiving drug coverage from Medicaid had to switch to the new scheme, a process that left millions unable to pay for their prescriptions for weeks in early 2006.
Source: crooksandliars.com

Utah Medicare Supplements

A Utah Medigap (also called Utah Medicare Supplement Insurance) policy is private health insurance that is designed to supplement Original Medicare. This means it helps pay some of the health care costs (gaps) that Original Medicare doesn’t cover (like copayments, coinsurance, and deductibles). If you are in Original Medicare and you have a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs. Then your Medigap policy pays its share. (Note: Medicare doesn’t pay any of the costs for you to get a Medigap policy.)
Source: utahseniorservices.com

Medicare Supplement Plan F

Medicare Supplemental Plan F is the most popular supplemental plan because it provides the most robust coverage, and the premiums are not much higher when the benefits are compared to the plans offering less coverage. A patient with Plan F can in many situations pay nothing additional out of pocket for doctor and hospital services. People eligible for a Medicare Supplemental Plan should compare the benefits and premiums of the plans and purchase the best coverage they can afford. For many patients, that is Plan F.
Source: wastedenergy.net

Is AARP The Best Carrier For Plan F?

Medicare supplement insurance plans are basic health insurance policies that are sold to consumers via private insurance companies.  These plans help to cover some of the out-of-pocket costs associated with medical expenses.  The AARP Medicare Supplement for Plan F is designed to help pay for some or all of the expenses that the original Medicare does not pay for – such things as coinsurance, office fees, and deductibles.  You should go over the Plan F details before you decide to find out if you are gaining privilege to all the possible benefits of the plan.
Source: recruitingblogs.com

An Explanation Of Medicare supplement plan F

Medicare supplement plan F is the most sought after Medicare supplement plan because it provides the most coverage. It is also the most expensive of the plans. Medicare supplement plans cover the deductibles in part A, which is the hospital portion of Medicare, and the 20% that Medicare does not cover, which is the doctor’s portion of the plan. The plans are labeled plans A, B, C, D, F, G, K, L, M, and N.
Source: willkapampa.org

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September 21, 2013

OIG: Tufts Medical Center Overbilled Medicare $1.1M

Posted by:  :  Category: Medicare

Previously, the OIG reviewed Tufts and said the hospital incorrectly billed Medicare inpatient short stays and same-day discharges in 2009 and 2010. However, the OIG’s previous report needed “further evaluation” on the inpatient claims, which resulted in this most recent report.
Source: beckershospitalreview.com

Video: Welcome to Tufts Health Plan Medicare Preferred

Tufts Health Plan Medicare Preferred Information Table

Tufts Health Plan Medicare Preferred will hold an Information Table for senior citizens in Shrewsbury community. The Information Tables are part of Tufts Health Plan’s statewide effort to provide seniors with the opportunity to meet with Tufts Health Plan Medicare Preferred representatives and provide general information about Medicare Advantage-type plans, review enrollment periods and answer questions.
Source: patch.com

Tufts Medicare Advantage?

For a company Ive never heard of they sure do have a lot of Med Advantages in your state. Tufts Medicare Preferred HMO Basic $16.00 Tufts Medicare Preferred HMO Basic $0 Tufts Medicare Preferred HMO Basic Rx $38.00 Tufts Medicare Preferred HMO Basic Rx $22.00 Tufts Medicare Preferred HMO Basic Rx Plus $48.00 Tufts Medicare Preferred HMO Basic Rx Plus $32.00 Tufts Medicare Preferred HMO Prime $96.00 Tufts Medicare Preferred HMO Prime $72.00 Tufts Medicare Preferred HMO Prime Rx $118.00 Tufts Medicare Preferred HMO Prime Rx $94.00 Tufts Medicare Preferred HMO Prime Rx Plus $128.00 Tufts Medicare Preferred HMO Prime Rx Plus $104.00 Tufts Medicare Preferred HMO Value $58.00 Tufts Medicare Preferred HMO Value $42.00 Tufts Medicare Preferred HMO Value Rx $80.00 Tufts Medicare Preferred HMO Value Rx $64.00 Tufts Medicare Preferred HMO Value Rx Plus $90.00 Tufts Medicare Preferred HMO Value Rx Plus $74.00 Tufts Medicare Preferred PFFS Basic $50.00 Tufts Medicare Preferred PFFS Basic $45.00 Tufts Medicare Preferred PFFS Basic Rx $72.00 Tufts Medicare Preferred PFFS Basic Rx $67.00 Tufts Medicare Preferred PFFS Basic RxPlus $82.00 Tufts Medicare Preferred PFFS Basic RxPlus $77.00 Tufts Medicare Preferred PFFS Prime $111.00 Tufts Medicare Preferred PFFS Prime $92.00 Tufts Medicare Preferred PFFS Prime Rx $133.00 Tufts Medicare Preferred PFFS Prime Rx $114.00 Tufts Medicare Preferred PFFS Prime RxPlus $143.00 Tufts Medicare Preferred PFFS Prime RxPlus $124.00 Tufts Medicare Preferred PPO $87.00 Tufts Medicare Preferred PPO $82.00 Tufts Medicare Preferred PPO Rx $109.00 Tufts Medicare Preferred PPO Rx $104.00
Source: insurance-forums.net

Social Security and Medicare Forum at Tufts

Christie Hager, representing the HHS Secretary Kathryn Sebelius and by extension the Obama Administration, touted the achievements made by the Administration, saying there was, “Historic good news about Medicare,” adding, “These historic benefits include discounts in prescription drugs, in the donut hole,” and preventative services. “[By] keeping you well before you need more costly and more risky medical care.” Hager also stated that her agency along with the Department of Justice has, “Recovered over 10 billion dollars in four years in fraudulent claims.” This in the last four years.
Source: thesomervillenews.com

Definition For HMO, HMO Stand For, HMO Health Insurance Plans, : TUFTS MEDICARE PREFERRED HMO 2012 FORMULARY

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Source: projectedu.com

Tufts Health Plan: Keeping Data Security Healthy

About Tufts Health Plan Tufts Health Plan is a nonprofit organization nationally recognized for its commitment to providing innovative, high-quality health care coverage. The plan offers members and employers an array of health management programs, which support evidence-based approaches to health and wellness. Quality is a hallmark of the plan: its HMO and POS are ranked second in the nation by the National Committee for Quality Assurance (NCQA)*. Its Tufts Medicare Preferred HMO earned a 4.5 star rating from the Centers for Medicare and Medicaid Services for 2013. Network Health, a subsidiary of Tufts Health Plan, is ranked third in the country for Medicaid plans, according to NCQA Medicaid Health Insurance Plan Rankings 2012-2013. Headquartered in Massachusetts, Tufts Health Plan also serves members in Rhode Island. Visit us at www.tuftshealthplan.com.
Source: axistechnologyllc.com

Inspector General Faults Medicare for Not Tracking ‘Extreme’ Prescribers

The inspector general’s report calls on the Centers for Medicare and Medicaid Services (CMS), which oversees the program, to step up scrutiny of doctors with questionable prescribing patterns. It urged CMS to direct its fraud contractor to expand its analysis of prescribers and train the private insurers that administer Part D on how to spot problem prescribers.
Source: propublica.org

CVS Caremark mailing error exposes prescription information

The “medication information” letters went out to the wrong addresses in late January and early February, mostly to members in Massachusetts. Each letter included another member’s name, the name of a drug prescribed, and the general types of conditions that treatment is used for, according to CVS Caremark, based in Woonsocket, R.I.
Source: phiprivacy.net

Roundup: Fla. Medicare HMO Closed; Tufts And BCBS Resume Talks

NewsHour: Kids With Toothaches: Lost In The Health Care Debate Teeth are crucial. When free health care clinics for poor people are held in California, the number one activity is extractions. The California Dental Association says the top chronic childhood disease is tooth decay. But a third of Americans say they skip dental checkups because of the cost. Until 2009, in California, dental care was part of Medicaid, or Medi-Cal as it’s called in California. More than three million poor, disabled and elderly adults had been eligible for subsidized care of their teeth. But cash-strapped California, looking for ways to save money, eliminated dental care for adults under Medi-Cal two years ago, and pocketed $109 million. At the same time the state gave up $134 million in federal matching funds (Michels, 11/17).
Source: kaiserhealthnews.org

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