Report Shines Light on Long-Term Care Spending in Medicare
By Anne Tumlinson Several contributors to THCB have commented that long-term care tends to get short shrift in healthcare discussions ... Medicare spending. Hospice trends help to illustrate this issue. Medicare covers palliative care ... these individuals represent only 7% of the Medicare population, they account for nearly 25% of spending in Medicare [more...]
Date: 2009-01-30 23:28:03
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GAO Report: Medicare Advantage Exposes Seniors To Serious Financial Risks
When lawmakers approved the Medicare Modernization Act, they offered an extra subsidy to Medicare Advantage plans (MA) ... obtaining services, a practice that may have violated laws governing PFFS plans. Medicare FFS plans, HMO ... . The deal was this: Medicare would pay about 13 to 17 percent more for beneficiaries enrolled [more...]
Date: 2008-12-16 14:28:55
Medicare Advantage Plans Stand to see some substantial decreases from the Government
Payments to insurers that provide Medicare Advantage plans are determined by a formula or algorithm ... and Whistleblowers This is related to Medicare Advantage plans, which have been a huge source ... - WSJ.com Technorati Tags: Medicare , Medicare Advantage , Heatlhcare , Health Insurance , Obama [more...]
Date: 2009-02-28 02:04:00
Medicare Advantage Open Enrollment Offers One-Time Chance To Change Your Mind: Allsup Outlines Rules For Switching Plans
Although annual Medicare enrollment has ended, some Medicare Advantage beneficiaries can still switch their coverage during the current Medicare open enrollment period. That information comes from Allsup, a leading provider of Social Security disability, financial and healthcare-related services to people with disabilities. [more...]
Date: 2009-01-13 08:00:00
Putting an End to Medicare Fraud
When Medicare was signed in to law by President Johnson in 1965, it was intended to serve as a central funding resource for persons over 65 years, ... medical pool that Medicare is — providing healthcare resources to innumerable people in need ... healthcare practices by healthcare companies and individuals abusing their benefits have contributed greatly [more...]
Date: 2008-08-19 07:50:18
Medicare Prescription Drug Enrollment Starts On November 15
Medicare encourages beneficiaries to review and compare their current health insurance coverage using enhanced online tools. The Centers for Medicare & Medicaid Services (CMS) today is reminding people with Medicare that, starting November 15th, they will be able to make changes in their health insurance [more...]
Date: 2008-11-14 16:45:00
Profit Motif in Health Care
As I approach that age when Medicare is available, I am becoming very aware that the system is in desperate straits ... turning away Medicare patients because they can’t pay the fees the doctors routinely charge for services ... to quality of service in the medical professions. Medicare costs vary wildly across the country [more...]
Date: 2009-02-26 16:22:59
Let People Buy Into Medicare Until New Plan Ready
I was part of a group who had lunch with former Presidential candidate Michael Dukakis a couple of days ago ... . * Every doctor's office already handles Medicare claims, so this would greatly reduce the current ... people buy into Medicare at cost today, while health care reform is worked out. I've been thinking [more...]
Date: 2009-03-01 22:37:57
Medicare Advantage Plans
[EDITORIAL NOTE: Pulitzer Prize-winning journalist Saul Friedman writes the bi-monthly Reflections column for Time Goes By in which he comments on ... _reflections I don’t wish to alarm you. But did you know that many of people on Medicare - more that 8.6 million of you - are inadvertently helping to kill Medicare? I don’t blame [more...]
Date: 2008-12-23 10:31:22
2009 Medicare Deductibles
The 2009 premiums, co-pays and deductibles are as follows: Part A Premiums : (Hospital) ... out of pocket expenses, a person with both Medicare A & B should look into either a Medicare Supplement or Medicare Advantage plan. www.JohnConner.com . John Conner 800-700-1246 [more...]
Date: 2009-03-05 18:05:42
MAC Transitions
Essential to the contracting reform program in the Medicare Modernization Act of 2003 was to acquire competitively procured contracts that conform to ... to MACs commenced in March 2007, of late the Centers for Medicare and Medicaid Services (CMS) issued ... the Federal Acquisition Regulation (FAR). Fifteen new Medicare Administrative Contractors (MACs [more...]
Date: 2009-03-05 16:59:21
THE FEAR WE NEED
The most successful Democratic campaign strategy is to frighten the elderly into voting for them by accusing the GOP of plotting the demise of ... claim that John McCain plans to cut Medicare benefits. He says that "Senator McCain would (make) $882 billion in Medicare cuts to pay for an ill-conceived health care plan, even as Medicare already [more...]
Date: 2008-10-22 13:37:54
Dean: ‘I Don’t Think We Should Impose A Single-Payer On Everybody’
In an interview with ThinkProgress yesterday, Gov. Howard Dean laid out the principles that he thinks should guide the health care reform debate ... essentially buy into Medicare,” Dean said. If Obama enacts health reform that contains a public plan ... choose Medicare, but not all of them will choose Medicare. So we will have a hybrid system. Many [more...]
Date: 2009-03-04 23:38:22
The Silence Of The Left
by hilzoyBen Smith at Politico has a story called 'Left Silent On Social Security, Medicare': "Strikingly, however, ... . We do have a problem with Medicaid and Medicare, but that is due to the fact that we have a much more general problem with rising health care costs. Spending on Medicaid and Medicare has risen less rapidly [more...]
Date: 2009-02-12 03:59:22
THE "RATIONING PROBLEM" IN MEDICAID, MEDICARE
Massachusetts Democratic Senator Ted Kennedy says he is "looking forward to working with Barack Obama on health care ... and lowering the age of eligibility for Medicare. According to Goodman:What that means is putting ... problem in Medicaid; now we're beginning to see one in Medicare. Goodman backs what he says are two good [more...]
Date: 2008-11-25 15:21:41
How To Win Your Medicare Claim Appeal
by Argo Sparks Asking seniors to pay for medical care after their medical claims get rejected is just unfair, but quite frequently, ... -appeal for the Medicare claim. Normally, people do this if the claim has been refused or settled ... out a re-determination form (Form CMS-20027), which is available at the Medicare website, within 120 days [more...]
Date: 2009-03-05 23:46:34
New RiskAnalyzer Software to Help Medicare Advantage Plans Manage Risk Adjustment
RiskAnalyzer Incorporates Johns Hopkins ACG System for Provider Profiling, Predictive Modeling, Resource Management and Rate Adjustment BIRMINGHAM, Ala., Feb. 19 /-- DST Health Solutions today announced the launch of its new Medicare risk ... provider coding is not capturing disease conditions under the Centers for Medicare ... [more...]
Date: 2009-03-05 22:17:07
The Medicare Claims Process And You
by Don Bethune Currently 43 million Americans have Medicare and that number is growing drastically because of aging baby boomers. Medicare is the largest purchaser of managed health care in the country and it is imperative ... in 1965. It consists of coverage in two parts. There is aPart A-Hospitala and there is aPart B-Medicala [more...]
Date: 2009-03-06 14:47:33
In Wednesday's Letters to the editor
antonio villaraigosa, barack obama, mutt, mormons, proposition 8, gay marriage, protests, medicare, letters, opinion l.a. ... , writes: The demonstrations against Proposition 8 make me question my vote against it. The behavior ... of the Centers for Medicare and Medicaid Services apologizes for delays in Medicare reimbursements [more...]
Date: 2008-11-12 09:00:34
U.S. doctors often skip key test before surgery
CHICAGO (Reuters) - People on Medicare who get elective surgery to open blocked heart arteries often do not get the recommended stress tests to ... the artery. PCI costs Medicare, the U.S. government's health insurance program for people age 65 and older, $10,000 to $15,000 per procedure and has contributed significantly to increases in Medicare [more...]
Date: 2008-10-14 15:42:17
Medicare Advantage Benefit Design: What Does It Provide, What Doesn?t It Provide, and Should Standards Apply?
This AARP Public Policy Institute research report by Marsha Gold and Maria Cupples Hudson analyzes recent changes in Medicare Advantage (MA) benefit design. It finds that MA plans have utilized the flexibility afforded them under the law to modify the structure of traditional Medicare benefits in important ways. (38 pages) [more...]
Date: 2009-03-06 21:33:00
Government Health Plans
by Jeff Cline The U.S. Census says that the number of uninsured Americans is at an all time high. They point to many factors as the cause for this ... the resources to find out if you or someone you know is eligible. Medicare is most popular ... disabilities no matter their age. Medicare has 2 parts. Part A is free and is the Hospital Insurance [more...]
Date: 2009-03-04 11:17:19
Georgia Medicare Beneficiaries Informed Of New Marketing Quidelines
The Department of Human Resources Division of Aging Services (DAS) ... by the Centers for Medicare and Medicaid Services (CMS). The new rules are designed to protect Medicare beneficiaries from being pressured to change their health care coverage plans by insurance companies [more...]
Date: 2008-09-29 11:01:12
Obama pushing ahead with Medicare Advantage changes
The Obama Adminstration convened a summit meeting today to get the conversation rolling on health care reform. But the President already has a clear idea of how he wants to reform Medicare Advantage, the managed care programs offered by private health insurance companies. Medicare Advantage plans bundle [more...]
Date: 2009-03-05 20:44:38
Medicare to Cover Prescription Handguns?
We recently reported about a new 9mm handgun that was designed for folks suffering from arthritis and other disabilities affecting the hands ... in accordance with 21 CFR 890.5050 “Daily Activity Assist Device.” We have now submitted an application ... for qualified patients who may seek reimbursement through Medicare or private health insurance [more...]
Date: 2008-12-03 17:22:32
Fix the right problem
It’s going to be a wild few weeks in Washington, as Congress begins to debate President Obama’s first budget ... are getting out of control, private insurance makes you grit your teeth, and Medicare is a pain. You think ... when compared to to Medicare! But before we start to run around and make things worse by trying [more...]
Date: 2009-03-03 00:00:49
How To Win Your Medicare Claim Appeal
How To Win Your Medicare Claim Appeal Updated on Thursday 5 March, 2009, under Health by Argo Sparks Medicare claims can be very beneficial for seniors, as it helps them sustain their health treatments. Yet, what a lot of people dont know is that medical claims [more...]
Date: 2009-03-05 23:44:13
Medicare for All
From Government Executive : Medicare’s relatively low overhead makes it a better model for a publicly run health insurance option for people ... and would set strong benchmarks for private health insurance providers, Hacker said in a briefing paper ... without employer-provided coverage than the Federal Employees Health Benefits Program, a health [more...]
Date: 2008-12-18 13:52:29
SENIOR’s BENEFITS
A reverse mortgage is a loan available to seniors, and is used to release the home equity in the property as one lump sum or multiple payments ... . The good news is there are both federal and state laws that govern the various Medicare supplemental health ... who wants to apply for a loan to secure a medicare supplemental insurance .Senior citizens [more...]
Date: 2009-03-06 02:30:58
How To Get Physicians To Use The Same Science-Based Playbook
Pretty much everyone agrees that we need to improve the quality of healthcare delivered to patients in the US ... on additional rules, regulations, and penalties to inspire change (for example, decreasing Medicare payments ... in practice patterns. In fact, at the recent Medicare Policy Summit, CBO staff identified this problem [more...]
Date: 2009-02-26 13:00:20
Taxes Will Rise
In light of the recently announced Federal budget—complete with $1.7 trillion deficit—we found David Leonhardt’s article this week interesting ... . “Like Having Medicare? Then Taxes Must Rise”Your taxes are going up. They will probably ... . And what might that economic reality be? The hard demographic reality of Medicare and other federal [more...]
Date: 2009-02-28 14:00:21
NewsBytes
From around the way. Okole Maluna brings Hawai’i to Colorado We drove an hour north from our house last night, to dine in Hawai’i ... of the Medicare Payment Advisory Commission, a group that advises Congress on Medicare payment ... officers relied on “incorrect assumptions and inaccurate data” to guide him back to the plane’s base [more...]
Date: 2009-03-04 11:07:52
Inertia in Government and Military Spending
Over a year ago, in Habit’s Impact on Freedom, I discussed ways that habit and custom constrain our freedom, sometimes harmfully, ... of contract to its population: Pay taxes specifically for Social Security and Medicare, during your working ... : support for the elderly, as Social Security payments and Medicare (government-provided health care [more...]
Date: 2009-01-11 19:00:28
How to Win Docs and Influence Patients
By Val Jones MD Pretty much everyone agrees that we need to improve the quality of healthcare delivered to patients ... rules, regulations, and penalties to inspire change (for example, decreasing Medicare payments ... in practice patterns. In fact, at the recent Medicare Policy Summit, CBO staff identified this problem [more...]
Date: 2009-03-02 14:48:36
Health Care Delivered as It Should Be
Hardly anyone has a good word to say about this country’s fragmented system for delivering and paying for long-term care, with one exception: ... , for an annual fee generally paid by Medicare and Medicaid. The care can be delivered at home, a PACE center ... embraced by Congress, which eventually authorized all PACE programs as Medicare providers.The [more...]
Date: 2009-01-08 13:20:28
Sounding Like The DLC
Gee, he really does sound like a Republican, doesn’t he? All Social Security needs is for them to remove the earnings cap ( ... public pension plan. As for Medicare spending, well, nothing wrong with that that single-payer ... Security and Medicare would be “a central part” of his administration’s efforts to contain federal [more...]
Date: 2009-01-08 15:10:33
President Obama: “I work for the American people”
F or quite a while I’ve been hoping to see a time when an American president would come along to echo FDR’s struggle against the forces of greed and ... competitively to continue offering Medicare coverage, but that’s how we’ll help preserve and protect Medicare and lower health care costs for American families. I know that banks and big student [more...]
Date: 2009-03-02 19:01:14
Busting the Ghosts of Hope
Expectations for Barack Obama’s presidency have continued to soar since his historic election. Millions believe change is possible ... in spiraling healthcare costs. WHAT WE NEED: Medicare for all! Established in the 1960s ... have to be increased to bring everyone into Medicare, but most people’s healthcare costs would go down while [more...]
Date: 2009-01-16 16:44:52
Golf carts, green cars exempt from pork ban? A PORKULUS MAD-HOUSE!
Obama’s promise to ‘change’ allows $7.7 billion in earmarks This is all coming out of American’s future paychecks in about 2 years or less ... in the form of “Federal Withholding”, Payroll taxes, FICA taxes and medicare taxes, because ... will have to come out of all American paychecks to pay for Social Security and Medicare ALONE, over and above [more...]
Date: 2009-03-06 17:42:12
MEDICARE FRAUD STOPPED IN ITS TRACKS
Orthofix is a diversified company that supplies orthopedic products and its chairman has courageously rejected a nominee to its board of directors ... , that the subsidiaries violated the False Claims Act by submitting claims to Medicare without proper ... , the company, paid $35 million to the United States government to resolve the fraud allegations, as [more...]
Date: 2009-03-03 15:14:33
A certain casualty of the recession: the US Government’s solvency
Summary: Whatever happens during this recession, one thing is almost certain: the US government’s balance sheet will be trashed ... , medicare, etc). That’s bad, perhaps beyond our ability to pay by means of future taxes ... , and social services. renege on our promises — cutting pensions, social security, medicare via taxation [more...]
Date: 2008-11-25 00:01:22
Heard Around The Blogosphere, 12.15.08
I hope you enjoy this week’s round up of quotable quotes from the medical blogosphere… Scalpel or Sword quotes Taiwanese hospital administrator who ... actually draws a starker picture. Hospitals collectively lose $30 billion on Medicare and Medicaid ... the provider operating deficit created by Medicare and Medicaid. Paul Levy: There are two types [more...]
Date: 2008-12-15 11:51:55
Options other than big health fund (Feb 28)
By Chuck Doud The Madera Tribune It is a good thing that President Obama is going to try to tackle the increasing costs of health care in the ... sell supplemental policies. Only about 7 percent of the cost of Medicare goes for administration ... . It’s called Medicare. It is restricted mostly to those over the age of 65, but why not expand [more...]
Date: 2009-02-28 08:12:17
Medicare's dismal pay for performance
Their embarrassingly small 1.5% bonus payments have physicians questioning whether the extra record-keeping is worth it: It took a lot of paperwork and screwed up billing because we had to charge 1 cent per code so that the Medicare carrier's computer would pick up the charges, and then had to manually write off [more...]
Date: 2008-08-29 14:24:42
Universal Healthcare on the Horizon
Gov. Kathleen Sebelius of Kansas was recently named as Obama’s new nominee for the secretary of Health and Human Services ... of Medicare is deteriorating because of the recession, according to new information from federal officials, and the Medicare trust fund could be depleted several years sooner than expected. Well [more...]
Date: 2009-03-03 19:21:57
The Lawsuit
The Lawsuit A couple of weeks ago I wrote that Brian Day and his followers had launched a lawsuit against the province, alleging that, “in contravention of the value of individual choice,” the Medicare Protection Act restricts ... about the Statement is not the government’s defence of medicare, but rather the Counterclaims against [more...]
Date: 2009-03-04 23:04:00
Moving the Goal Posts
From the Committee for a Responsible Budget : In constructing their budget baseline – the metric against which the costs of policy changes are ... will continue to enact “Medicare Pay Patches;” and 5) funding will be allotted for anticipated ... , making the 2001 and 2003 tax cuts permanent, and the costs of not abiding by the slated Medicare [more...]
Date: 2009-02-27 10:25:00
WOULD EARLY OPT-INS TO MEDICARE BE A BOOST OR A BURDEN?
Medicare kicks in at 65 for most Americans. But an early buy-in would allow someone as young as 55 to enroll in the program and pay a higher ... in their late 50s or early 60s could plug a gaping hole in the nation's health care safety net, say experts ... insurance in the private market because of health problems; thus, it would end up helping only [more...]
Date: 2009-01-19 13:39:57
Alternatives To Medicare Coverage
by Don Bethune There are many options available to those people who want to stop their Medicare coverage ... is more economical in the long run because you wonat have to pay for medical check-ups, tests ... who require frequent medical check-ups may find this option uneconomical. On the other hand however those [more...]
Date: 2009-03-02 12:19:41
Single payer is not socialized medicine, it's "Medicare for all"
Merrill Matthews, executive director of the Council for Affordable Health Insurance writes a letter to the Kansas City Star: ... be like Medicare without the Medigap policies. The insurance industry would stay in business by insuring cars, property, life, and many other insurance products. But they would no longer be permitted [more...]
Date: 2008-08-08 16:20:25
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