MEDICARE

Medicare for Autism Now Society www.medicareforautismnow.org Medicare for Autism Now-BC Campaign Rally and Ontario Tour Vancouver, BC:- The Medicare for Autism Now Society today announced it will be holding a campaign rally on Saturday, October 4, 2008 beginning at 2:00 p.m. at the Eaglequest Golf and Country Club, 7778 - 152nd St. in Surrey. This rally is part of the society’s “Two

Medicare for Autism Now! Rally Saturday, October 4th, 2008 2:00 p.m. to 4:00 p.m. Eaglequest Golf Club, 7778 – 152nd St., Surrey, BC, V3S 3M4 Why should I attend? • Despite a decade of lobbying, collaborating and litigating – autism treatment is still excluded from our universal health care system. Canadian families from BC to Newfoundland and everywhere in between are still bankrupti

The Epoch Times in Parents Lobby Swing Ridings in Autism Fight by Joan Delaney features the Medicare for Autism NOW! Two Percent Solution campaign for autism coverage in Medicare. The article includes commentary by Senator Jim Munson, Medicare for Autism NOW! activists Louise Witt and Beverley Sharpe, and humble parent advocate Harold Doherty from New Brunswick. autism

WASHINGTON – Cooper University Hospital in Camden, N.J., has agreed to pay the United States $3.85 million, plus interest, to settle allegations that it defrauded Medicare, the Justice Department announced today. The settlement resolves allegations that the hospital improperly increased charges to Medicare patients to obtain enhanced reimbursement from the federal health care program. In additio

WASHINGTON – A federal jury in Los Angeles today convicted the owner and operator of Pacific City Group Inc., a Los Angeles based durable medical equipment (DME) company, of defrauding the Medicare program, Acting Assistant Attorney General of the Criminal Division Matthew Friedrich and U.S. Attorney for the Central District of California Thomas P. O’Brien announced.After a one-week trial in f

CMS is slowly but surely adding some codes for payment of limited telehealth services -- this year, it's certain consultations to follow up on patients the remote physician has seen in person. I spoke with the editor of Physician Compensation...

The non-partisan efforts of the Medicare For Autism Now Campaign are featured in a Sun Media article on C-Health. The article includes comments from long time autism activists Louise Witt of Surrey, British Columbia and Andrew Kavchak of Ottawa, Ontario. Both Louise and Andrew stress the non-partisan nature of the campaign. Candidates from two political parties are also featured as supporting

YvesVilleneuve an Independent candidate for Parliament in the Nickel Belt, Ontario riding says he would support amending the Canada Health Act to require funding of autism treatment: I would definitely support legislation to amend the Canada Health Act to force the funding for Autism treatment. I would certainly personally introduce this legislation in the House of Commons and keep

Medicare for Autism Now! Rally Saturday, October 4th, 2008 2:00 p.m. to 4:00 p.m. Eaglequest Golf Club, 7778 – 152nd St., Surrey, BC, V3S 3M4 Why should I attend? · Despite a decade of lobbying, collaborating and litigating – autism treatment is still excluded from our universal health care system. Canadian families from BC to Newfoundland and everywhere in between ar

"As a veteran American senator once observed, politicians see the light when they feel the heat. We launched the Two Percent Solution in five ridings in the last elections, and I believe we had some impact on the outcome in two of them. We punched above our weight the first time, and I think this time out the campaign has real potential for democratic renewal. This isn't a partisan effort. It

by Dave MindemanIt's that time of year again. Time for the doughnut holes.I'm a pharmacist and at this point of the year I go into explanation mode in repsonse to the raised eyebrows, quizzical stares, and looks of exasperation. It's time for that senior doughnut hole moment.In prescription drug coverage, pharmacies that deal with Medicare coverage -- and that would be pretty much all of us -- h

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, and people with disabilities. Over the years millions of people have benefited from the financial medical pool that Medicare is — providing healthcare resources to innumerable people in [...]

Older patients with heart disease and diabetes are getting better treatment than ever at the University of Michigan Health System -- even while U-M's care for Medicare patients is costing less, a new report shows. The data come from the second year of a national project undertaken by 10 large physician groups, including the U-M Faculty Group Practice.The results were announced in Washington, D.C.,

Nova Scotia has been in the news recently as a result of losing two valuable medical professionals, a husband and wife, who are moving from Nova Scotia to Manitoba so their autistic child can benefit from the autism treatment services at St. Amant. Ontario has also seen a number of news articles - Canada.com, Toronto Sun, Hamilton Spectator, and Welland Tribune featuring the plight of Ontario's

The Welland Tribune is reporting the heart wrenching story of 4 year old Branden Hayward of Welland, Ontario. Branden has an autism spectrum disorder and has been on a waiting list for Intensive Behavioral Intervention (IBI/ABA) for the past two years. His mother Stacey was told just 3 weeks ago that Branden would begin Therapy in September because he had made his way up one of Ontario's

More proof that Canada needs Medicare coverage for Autism NOW can be found in the CP/Globe & Mail article Agencies decry Ontario's funding of child autism treatment by Maria Babbage. From Northern Ontario to Toronto and London non-profit agencies are underfunded and forced to cut services. Autistic children are losing out. Children are continuing to wait for a place on the lists to receive tr

Yesterday both the House of Representatives and the Senate override the President's veto of bill HR6331/S3101. The House vote was 383 - 41, while the Senate voted 70 - 26. Congress accomplished... [[ This is a content summary only. Visit my website for full links, other content, and more! ]]

Today President Bush veto bill S3101/HR6331. Now the bill must go back to House of Representatives and the Senate for the bill to be override. There's suppose to be enough votes to over ride the... [[ This is a content summary only. Visit my website for full links, other content, and more! ]]

As of this afternoon the President still has not sign bill S3101. As you know Medicare started processing claims as of July 11, 2008. The cap is in-effect with no exceptions and there will be a 10.6%... [[ This is a content summary only. Visit my website for full links, other content, and more! ]]

One step closer to keeping the physical therapy exception cap and stopping the 10.6% reduction in the physician fee schedule. The Senate pass bill S3101 today by 69 - 30. The bill will now travel to... [[ This is a content summary only. Visit my website for full links, other content, and more! ]]

Congress couldn't be bothered to stop grandstanding before July 4th long enough to undo the latest SGR-driven physician pay cut (over 10%). This week, CMS rolled out its 2009 MPFS with an SGR-mandated 5.7% cut in place, while at the...

Rumor has it, the Senate will bring a cloture vote to floor on Wed,July 9, 2008 concerning bills S3101 and S3118. Cloture is " a parliamentary procedure by which debate is ended and an immediate vote... [[ This is a content summary only. Visit my website for full links, other content, and more! ]]

Medical advancements and more breakthroughs are creating many different drugs to counter off those pesky illnesses that sure cause a lot of people to get sick and their life strongly affected by it, living a clean life is a start but it simply is not that simple when you’re getting older. Having a medicare advantage is [...]

I really wonder how senior citizen life here in the Philippines would be if they will be having a medicare supplement catered every week or month by the government. A medicare in which hospitalization, doctor visits, skilled nursing, medical tests, diagnostics and other services are being offered. I just love how we would be giving [...]

On Tuesday, June 24, 2008 the US House of Representatives pass the bill (HR 6331), Medicare Improvements for Patients and Providers Act. This bill will prevent a 10.6% decrease in payment under... [[ This is a content summary only. Visit my website for full links, other content, and more! ]]

By: John Deutsch, EMR Experts, Inc. (www.emrexperts.com)Is anything ever free these days? Maybe so. Instigated by the incredibly slow adoption of Electronic Medical Records (EMR) by doctors across the nation, Medicare is announcing it will begin offering doctors free electronic medical record software solutions.Both upfront and ongoing costs have been critical factors in the lagging EMR adoption r

There has been a lot in the news lately about the development of new drugs to treat mesothelioma. But with this boon comes a perhaps unforeseen complication - the increasing cost of treatment. A recent study conducted by the U.S. National Cancer Institute (NCI) and published in the Journal of the National Cancer Institute indicates [...]

Which of these three things do you think Sens. Grassley and Baucus did today? If you chose (C) Promote a Medicare payment fix and diss the folks across the aisle, you would be correct. The six-month reprieve for the formula-driven...

As of July 1, 2008 Medicare patients might have a cap on their physical therapy visits. Right now there is a financial cap but there are diagnoses that are exceptions to the cap. Medicare also plans... [[ This is a content summary only. Visit my website for full links, other content, and more! ]]

In a recent Press Release, the Acting Comptroller General of the United States announced the appointment of 3 new members and the reappointment of 2 existing members to the Medicare Payment Advisory Commission (MedPAC). The 3 new members, whose terms will expire in 2011, are Peter W. Butler, M.H.S.A., executive vice president and chief operating office of Rush University Medical Center in Chicago,

On May 29, 2008, the Congressional Budge Office (CBO) released an Economic and Budget Issue Brief entitled Accounting for Sources of Projected Growth in Federal Spending on Medicare and Medicaid. In the issue brief, the CBO projects that federal spending on Medicare and Medicaid will grow from 4 percent of gross domestic project in 2007 to 9 percent in 2032 and 19 percent in 2082. The CBO also rep

On May 22, 2008, the Centers for Medicare & Medicaid Services (CMS) released a display copy of a Final Rule to permit Medicare Part D claims data to be used for program monitoring, research, public health, care coordination, quality improvement, population of personal health records, and other purposes. The Final Rule allows CMS to disclose certain Medicare Part D claims data to other federal

On May 21, 2008, Senate Finance Committee Chairman, Max Baucus, issued a News Release following a meeting with the bipartisan membership of the Senate Finance Committee to discuss upcoming Medicare legislation. In the News Release, Chairman Baucus states the following: "In an effort to reach consensus on Medicare legislation before the Memorial Day recess, I've met repeatedly in recent days w

On May 8, 2008, the Department of Justice (DOJ) announced in a Press Release that the second phase of a Medicare fraud strike force began operations in Los Angeles, California on March 1, 2008. In the Press Release, the DOJ reports that the second phase has already resulted in 11 indictments involving almost $13 million in Medicare claims. In the Press Release, the DOJ reports that the Medicare fr

I occassionally will deviate from the normal topic of invoice factoring when I come across something in the news that really gets my attention.  My latest reason to rant and rave is the story about Cox Health System’s involvment in medicare fraud at the Ferrell-Duncan clinic in Springfield, Missouri.  Court filings indicate that the clinic [...]

Medicare is a federal program that provides health insurance to senior citizens irrespective of their medical condition. You can only qualify for Medicare if you are 65 years and above. Medicare would automatically register people who were receiving social security benefits once they reach the age of 65. People who decide [...]

In my country particularly in my place,Seniors dont have any benefits pertaining to their age.They got no support from the government.Best example is my Grandmother.She hasn't any pensions as she hasn't worked before.She is now living with my parent's help and any other family members,luckily.She's a stayed at home Mom and grandmom all her life.There is a chance to claim your pension if you reach the age of 60.But that pension will not all be guaranteed.The pension depends on how long you've work and how much you have contributed,part of the tax you paid.It takes more years before you can have it or never.I found this very disturbing because I am now living in a country where everything matters.Seniors are entitled to a medicare and got nothing to worry when claming it so long as they hav

We know that most senior citizen here in the country are on medicare, just to provide their needs on medical, dental, vision and some related medical essentials just to stay healthy. But we know that medicare doesn't covered up all necessary expenses, it has co-pays, deductibles on some services, moreover, the patient is still all responsible for all expenses not covered with medicare so, medicare supplements is here to provide you the safest way, just in case you need it. To have a supplementary insurance on the side is very important, just in case, you can't pay the deductibles or co pay, or some other expenses, Mature Health Center will do it all for you. At only affordable repayments on insurance coverage, you can rest assured you are all covered with all your needs. So, all you

There’s already been a lot of criticism of John McCain’s health care plan around the liberal blogosphere, including these posts from Steve Benen and Ezra Klein. One peculiar thing about McCain’s plans is that he manages to both ignore addressing the real problems of those who have lack affordable coverage and makes things worse for [...]

Medicare “drifting towards disaster”: U.S. official Medicare is lurching toward disaster and it is too late for the Bush Administration and Congress to do anything about it, U.S. Health and Human Services Secretary Michael Leavitt said on Tuesday. He said the next administration will have to act to stop rising costs and get control of the $400 [...]

The May issue of the Journal of the American College of Radiology (JACR) examines current trends in mammography utilization in the Medicare population - specifically, how digital mammography may be affecting the rate of women being screened for breast cancer, as well as validating data from recent reports that a decline in the overall screening rate for women over age 40 exists. Recent Trends in

if the actual addiction and alcoholism rates of the retiring baby-boomers is significantly higher that our current estimate of those rates, then the overall medical and related costs to be borne by the Medicare and Social Security Programs could be substantially higher than our current predictions. This, in addition to the already high projected [...]

Virtually everyone would agree that good health is one of the most important parts of life. If you’re one of the millions of Americans on Medicare, your benefits can help you live a fuller, more healthy life by ensuring you receive the treatment you need when you’re ill as well as the preventive services that [...]

It was a warm sunny day in Oakville yesterday as the Medicare for Autism NOW! team gathered at the Iroquois Ridge Community Centre to meet families in the communities west of Toronto, to organize and to send a message to ALL federal politicians: Canadians are suffering from a NATIONAL autism crisis. Some autistic children, depending on where they live, receive NO treatment for autism. The lack of treatment prevents some autistic children from living a full life and imposes emotional and financial hardship on family members.Many of us have talked about a National Autism Strategy to address Canada's national autism crisis for years. Some politicians of character and conscience, people like Senator Jim Munson and MPs Andy Scott, Peter Stoffer and Shawn Murphy have actively campaigned

Yesterday was a big day as Medicare for Autism NOW! met Sandie Rinaldo and CTVThe CTV camera crew sets upJean and David arriveGary from CTV briefs Stefan, Jean and DavidJean and Sandie Rinaldo prepare for the interviewAfterwards its over to the CTV Toronto offices in the Globe and Mailbuilding before heading out for lunchautism

The extent of the community need for treatment of mental health problems has been clearly demonstrated by the high uptake of the Better Access to Mental Health Care Medicare items, according to the Australian Psychological Society, accounting for the larger than expected costs. "However, surprisingly less than half the costs associated with the initiative involve treatment items by allied health professionals, mainly psychologists," said APS Executive Director, Prof Lyn Littlefield, "while GP Mental Health Care Plan and Review Medicare item number costs reflect almost as much as the treatment items, with a much smaller amount going to psychiatrists." In March 2008 the Australian Psychological Society (APS) conducted a survey to investigate use of the items among psychologists. Over 2000 p

Medicare very soon will no longer be the barrier it once was to retirees moving abroad, which opens the door to living where expenses are significantly lower. As insurance companies compete to manage your Medicare (They call them MedAdvantage programs), they will have no qualms about paying for your care in other countries. More: [...]

Medicare for Autism Now! campaign returns to Ontario Jean Lewis, chief spokesperson for FEAT-BC’s Medicare for Autism Now! campaign today announced that she and others, including Stefan Marinoiu, of Toronto, will be traveling through Ontario, organizing parents and supporters as part of a national initiative to obtain Medicare coverage for autism treatment. They will be holding a news conference on Parliament Hill, in the Charles Lynch Press Theatre, at 11:00am on Monday, April 14th. The news conference will be followed by a three day campaign swing through federal Health Minister Tony Clement’s constituency of Parry Sound-Muskoka, various media interviews in Toronto, on Friday, April 18th, and a concluding parent/supporter rally at the Iroquois Recreation Centre, in Oakville,

"Medicare for Autism Now!" Rally Saturday, April 19th, 20082:00 p.m. to 4:00 p.m.Iroquois Ridge Community Center,1051 Glenashton Drive,Oakville, Ontario, L6H 6Z4Why should you attend?* Despite a decade of lobbying, collaborating and litigating – autism treatment is still excluded from our universal health care system. Canadian families from BC to Newfoundland and everywhere in between are still bankrupting themselves in order to provide treatment for their disabled children.* The current and limited patchwork of funding and services provided through the provinces’ social services ministries could evaporate tomorrow with a change of government, or the stroke of a bureaucrat’s pen. No legislation or mandate exists within these social services ministries to deliver health care or to pro

The House Ways and Means Subcommittee on Health recently released a Hearing Advisory announcing that it will hold a hearing on the 2008 Annual Report of the Medicare Board of Trustees (Trustees). The hearing is scheduled to take place at 10:00 a.m. on April 1, 2008. The 2008 Annual Report was released on March 25, 2008. In the 2008 Annual Report, the Trustees indicate that the financial outlook for the...

So, for the third year in a row, those wild and crazy Medicare Trustees issued their report and have let us know we're living beyond our means. The Medicare funding warning was first triggered by the 2007 report and is...

So, for the third year in a row, those wild and crazy Medicare Trustees issued their report and have let us know we're living beyond our means. The Medicare funding warning was first triggered by the 2007 report and is...

Statement by Secretary Henry M. Paulson, Jr. on the 2008 Social Security and Medicare Trust Fund Reports. FULL STREAMING VIDEO. Reports from the Board of Trustees - Status of the Social Security and Medicare Program. also available in Adobe PDF FORMATWashington--The Social Security and Medicare Boards of Trustees met this afternoon to complete their annual financial review of the programs and to transmit the Trustees Reports to Congress. I welcome my Cabinet colleagues.For decades, Social Security and Medicare have provided vital support for millions of Americans. As the baby boom generation moves into retirement, these programs face progressively larger financial challenges. If we do not take action soon to reform Social Security and Medicare, the coming demographic bulge will jeopardiz

On March 25, 2008, the Department of Health and Human Services issued a Press Release announcing the release of the 2008 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (Report). In the Report, the Board of Trustees (Trustees) indicate that the financial outlook for the Medicare program continues to raise serious concerns. According to the Report, Medicare expenditures were...

It’s February again, and the millions of Americans who are currently on Medicare know what this season means: the time for open enrollment is quickly running out. Starting each year on November 15 and running through March 31, open enrollment gives individuals currently on Medicare the opportunity to change their Medicare coverage to either Original Medicare [...]

Health insurance has become quite complicated in the US, especially for those over 65. Medicare rules and regulations keep changing, and I know my parents have needed to buy extra supplemental medicare part d prescription plan insurance. There is a great internet resource, The Mature Health Center, which offers explanations of benefits along with quotes and resources from different major insurance companies. Tags: health care, health insurance, medicare, medicare part d, prescription plan, senior health, lynda lippin

On February 29, 2008, the Medicare Payment Advisory Commission (MedPAC) issued a News Release announcing the release of its Report to Congress: Medicare Payment Policy for 2009 (Report). In the Report, MedPAC makes updates and policy recommendations for certain Medicare fee-for-service payment systems for 2009. In brief, MedPAC recommends the following updates: Hospital Inpatient & Outpatient Services. MedPAC recommends that Congress increase payment rates in 2009 by the projected rate...

Sunday, March 2nd, 20082:00 p.m. to 4:00 p.m.Shadbolt Centre for the Arts6450 Deer Lake AvenueBurnabyWhy should you attend?Despite a decade of lobbying, collaborating and litigating – autism treatment is still excluded from our universal health care system. Canadian families are still bankrupting themselves in order to provide treatment for their autistic children.The current and limited funding provided through the provincial government’s social services ministries could evaporate tomorrow with the stroke of a bureaucrat’s pen. No legislation exists within these ministries to protect or enshrine our children’s medically necessary treatment.In 30 years of "advocacy", the only two initiatives which have achieved ANY success for our children and families has beenlitigation, and more

"Medicare for Autism Now!" Rally Sunday, March 2nd, 20082:00 p.m. to 4:00 p.m.Shadbolt Centre for the Arts6450 Deer Lake AvenueBurnabyDon't forget the Medicare for Autism Now Rally tomorrow March 2nd in Burnaby! Medicare coverage of autism treatment, particularly ABA, would ensure that all autistic children in Canada receive ABA coverage without regard for accidents of geography. It would also help ensure that ABA services that are provided are protected from erosion or loss resulting from that minority, but still common, and often influential, type of bureaucrat who places his, or her, career agenda before the interests of the autistic children they are supposed to help.Come out and voice your support for Medicare for Autism NOW! Voice your support for autistic children and their

The great thing about reading a study, or a report about a study, showing ... well, just for example, that EHRs don't save any money, or that drinking alcohol is good for you, is that, gosh darn it, there's always...

On February 28, 2008, the Centers for Medicare & Medicaid Services (CMS) released the Medicare recovery audit contractor (RAC) status document and a related Press Release for fiscal year (FY) 2007. In the status document, CMS reports on the results of the RAC demonstration project for FY 2007. Since March 2005, the RAC demonstration project has operated in the states of California, New York and Florida to determine whether RACs...

Randy Dotinga When Medicare began paying for older women to undergo preventive mammograms in 1991, doctors expected breast cancer mortality rates to drop. Breast cancer deaths did decrease, but new research has unveiled a discrepancy: African American women as a group do not benefit as much as white women. Breast cancer death rates for the two ethnic groups used to be nearly identical. "It

When Medicare began paying for older women to undergo preventive mammograms in 1991, doctors expected breast cancer mortality rates to drop. Breast cancer deaths did decrease, but new research has unveiled a discrepancy: African American women as a group do not benefit as much as white women. Breast cancer death rates for the two ethnic groups used to be nearly identical. "It looks like the

In addition to the prescription drug program, George Bush’s Medicare Plan provided for extra payments to private insurance companies to cover Medicare patients. Under these Medicare Advantage plans it now costs about twelve percent more to cover Medicare patients than under the government program, even though the private companies often cherry pick the healthiest patients. The extra payments also provide incentive for fraud. In light of the problems which have been identified with these plan, The New York Times has an editorial today calling for an elimination of the subsidies: Heavily subsidized private Medicare plans are continuing to prey on elderly Americans despite state, federal and industry efforts to stop them. It is yet another reason to rein in these operations by eliminating their unjustified subsidies. These plans are a financial drag on Medicare as the government pays them about 12 percent more, on average, than the same services would cost in the traditional Medicar

Aetna is now offering many new HMO Open access & PPO Plans in the state of Florida. See how their Medicare Advantage plans can help you. Are you currently on disability? Did you just turn 65 years of age? Get more information here...

By: Elmo Kandel We depend on the government to pass laws that are good for the people of this great country. And many laws that get passed do a great job of that. But one requirement of a law to be of any benefit to people is that we, the people, must be able to understand it. When it comes to this vast legal system called “Medicare”, the best way we can compliment the work of our government in making it understandable is, “Well, their hearts are in the right place.” Medicare is a system that was designed to help the elderly with their medical bills at a time of life when that help is needed the most. So, all cynicism aside, it is a system of laws that obeys that edit of seeing the government try to do the best for the people it serves. But many of us find Medicare confusing. And when laws are confusing, it is easy to think that this was done on purpose to keep people from taking advantage of the system. In the case of Medicare, it is more likely that the system become complex

Ezra Klein has an interesting  quote on how Republican false claims become regarded as fact, quoting from Health Affairs: ONE HUNDRED THIRTY thousand pages of Medicare regulations stifle provider innovation. We know that because conservative politicians such as Newt Gingrich tell us this every chance they get. The evidence? A decade ago, the estimable Mayo Clinic added up the pages; who, after all, doesn’t believe the Mayo Clinic? This nugget, demonstrating regulation run amok, even made it into the talking points that candidate George Bush used against Al Gore in one of their 2000 debates, although Bush managed to mangle the details. The only problem is that the number 130,000 is wrong—not just a little wrong, but about 127,500 pages wrong. I know this because as a senior political appointee at the Centers for Medicare and Medicaid Services (CMS), I was selected to defend the number in a congressional hearing. In fact, most of what Mayo counted as pages of regulations were newsl

Michelle Malkin has a post critical of WellCare which she calls “a shady Medicare insurer…initially funded by far Left billionaire George Soros.” I don’t know the specifics about WellCare and she might be correct in her criticism. However, as I’ve noted in several previous posts, the problems with Medicare Advantage plans are widespread, involving multiple insurance companies. Many of them are now under investigation for fraudulent practices. This has become a serious problem due to George Bush’s Medicare D program which also provided large subsidies for Medicare Advantage programs. I’ve criticized the entire program in multiple previous posts as being a case of corporate welfare to benefit Bush’s major contributors in the insurance and pharmaceutical industries while using government money ineffectively to benefit Medicare patients. This is true regardless of which individuals might be involved in the company. Interesting that she points out

The report of the Oversight and Government Reform Committee on the Medicare Part D Program provide more examples of how the plan was more a corporate welfare plan than a means to help Medicare beneficiaries. “Privatizing the delivery of the drug benefit has enriched the drug companies and insurance industry at the expense of seniors and taxpayers,” according to Henry Waxman.  (Pdf of full report). Key findings include: High administrative expenses. The private Part D insurers report administrative expenses, sales costs, and profits of almost $5 billion in 2007 — including $1 billion in profits alone. The administrative costs of the privatized Part D program are almost six times higher than the administrative costs of the traditional Medicare program. Small drug rebates. The drug price rebates negotiated by the Part D insurers reduce Medicare drug spending by just 8.1%. In contrast, rebates in the Medicaid program reduce drug spending by 26%, over three times as mu

Hinduja group firm Hinduja TMT has formed a joint venture with Limitless, the real estate subsidiary of Dubai World, to enter medicare realty business. The focus will be on complete range of healthcare services, including hospital services. Source (Economic Times) Technorati tags: Hinduja, HTML Ear Ring, Dubai World, Limitless, Healthcare real estate

We've had a couple customers call us regarding some changes that Medicare has made regarding billing. I just wanted to post how the Qualified Address solutions can help providers with this billing change.In the past, Medicare assigned the payment locality for services performed by looking up the county using a 5-digit ZIP Code. Unfortunately, quite a few ZIP Codes cross county lines. Medicare was running into problems with assigning the right county to an address using only the 5-digit ZIP Code and, starting October 1, 2007, has begun to require that some physicians and providers use a nine-digit ZIP Code when filing their claims.Qualified Address has a few solutions that can help physicians with this problem. First, we have a data cleansing service that will add the +4 Code to any valid a

We've had a couple customers call us regarding some changes that Medicare has made regarding billing. I just wanted to post how the Qualified Address solutions can help providers with this billing change. In the past, Medicare assigned the payment locality for services performed by looking up the county using a 5-digit ZIP Code. Unfortuantely, quite a few ZIP Codes cross county lines. Medicare was running into problems with assigning the right county to an address using only the 5-digit ZIP Code and, starting October 1, 2007, has begun to require that some physicians and providers use a nine-digit ZIP Code when filing their claims. Qualified Address has a few solutions that can help physicians with this problem. First, we have a data cleansing service that will add the +4 Code to any valid address. This solution costs as little as $29.95. For more information, please visit QualifiedAddress.com. This will update all the addresses currently in your database with the +4 Code. Secon

In response to the 2.7 billion dollars cuts to Medicare that were passed by the U.S. House of Representatives in the Children's Health and Medicare Protection Act (CHAMP Act), the long term care provider community today initiated an aggressive TV and print campaign in Congressional districts across the country. The campaign warns that proposed cuts will jeopardize ongoing quality improvements in America's nursing homes, threaten thousands of local health care jobs, and irrationally return Medicare funding levels to those seen almost a decade ago."The long term care profession strongly supports expanding the State Children's Health Insurance Program (SCHIP). However, this support should not be funded by raiding the Medicare funding that vulnerable seniors depend upon for quality nursing home care in facilities across the nation," warned Alan Rosenbloom, President of the Alliance for Quality Nursing Home Care ("the Alliance"). The Alliance is funding the ad campaign in conjunction wit

Humana Inc. (NYSE: HUM) yesterday announced that it is partnering with the Centers for Medicare and Medicaid Services (CMS) and other Medicare health plans in temporarily suspending marketing of its non-group Medicare Advantage Private Fee-For-Service (PFFS) product. This voluntary pledge only affects PFFS marketing to individual seniors and comes in response to concerns expressed by CMS regarding marketing practices across the sector. The Medicare Advantage group PFFS and individual HMO and PPO products are not affected by this decision."Protecting our nation's seniors through the integrity of the Medicare program is vitally important," said Michael B. McCallister, Humana's president and chief executive officer. "We take very seriously this pledge to partner voluntarily with CMS and our peers as we pause, step back and make necessary changes. It is consistent with our long-standing commitment to continuous quality improvement through our 20 years as a trusted Medicare contractor. We

Statement of President and CEO America's Health Insurance Plans Karen Ignagni on landmark industry pledge:"Taking a major step to give Medicare beneficiaries peace of mind, today seven of our member companies are making a pledge to voluntarily stop marketing non-group Medicare Advantage Private Fee For Service plans and to strengthen consumer protections by implementing now the Centers for Medicare and Medicaid Services (CMS) 2008 marketing enhancements ahead of schedule. This action will complement efforts already underway to ensure that brokers, agents and in-house marketing staff are appropriately trained and give beneficiaries additional assurances that they will have accurate, clear and useful information they need to understand their choices."On May 16th, our Board of Directors announced the industry's commitment to specific principles in this area that go beyond current regulatory requirements. We already have committed to increasing training and oversight across the industry.

Uninsured adults with common chronic illnesses had greater health expenditures and more frequent physician office visits and hospitalizations after they became eligible for Medicare compared with those who had insurance before age 65, according to a study published Thursday in the New England Journal of Medicine, Reuters reports. For the study, researchers from Harvard Medical School used data from the federal Health and Retirement Study to compare Medicare expenses for 1,385 people who were uninsured before becoming eligible for the program at age 65 and 3,773 who had private coverage before becoming eligible for Medicare (Emery, Reuters, 7/11).According to the study, 2,951 beneficiaries were diagnosed with either cardiovascular disease or diabetes -- conditions for which treatment can prevent severe consequences that can require extra doctor visits and hospitalization. Health care expenses were 51% greater for previously uninsured beneficiaries who were diagnosed with chronic conditi

Senate Republicans blocked the Medicare Part D negotiation bill that would allow the government to negotiate drug prices for the Medicare prescription drug benefit and they called it a victory for the Seniors.The bill would have allowed the Secretary of Health and Human Services to make deals with the pharmaceutical industry.Our Congress had already passed a stronger version, which would have made negotiations mandatory.President Bush said that he would veto either version of the bill if they came to him.Just who is this a victory for and why?

I do not know the Madison's personally, but painfully, their story hits home for many (TOO MANY) Americans:"Medicare's Sinkhole"Senior citizens stuck in drug program's coverage gapAt first, health insurance with the new Medicare prescription drug plan seemed like a good deal to Dave and Sharyn Madison.Then Dave Madison got cancer.That was when the Madisons found out about the "hole" in their drug plan.This month, their co-pay was $1,307 for the oral chemotherapy Dave Madison needs to fight his pancreatic cancer.That seemed like a lot, until they learned that in July, they'll have to pay the entire cost of that drug: $2,587."We've hit that doughnut hole," Sharyn Madison said.The "doughnut hole" is a designed coverage gap in the new Medicare program, which began in January.Almost 7 million senior citizens with Medicare drug coverage are expected to fall into the doughnut hole this year, according to a Kaiser Family Foundation study.The Medicare drug benefit's basic coverage, know

Corpus Callosum has great post about an article that appeared in the New England Journal of Medicine. He brimes with pride at the "venerable" journals departure from it's usual decorum in commenting on Medicare Part D. It is a worthy read, and a withering criticism from a high respected journal with starched credentials. Here is an excerpt from the grand ol' journal. Part “D” for “Defective” — The Medicare Drug-Benefit Chaos True, the program provides drug benefits for some Americans who previously had none. But because of its strange design, enrollment is falling far short of expectations. Officials in the Bush administration boasted that 25 million people are receiving benefits through Medicare Part D. But the government's data reveal that about 20 million of them already had adequate drug coverage through Medicaid, their employers or unions, or health maintenance organizations; as of late February, the new benefit was providing only 12 percent of the elderly with co

Having trouble with Medicare Part D? You aren't the only one. Knight Ridder Many of Medicare's poorest and most sickly patients are going without their medications because of administrative glitches, misinformation and confusion surrounding the new Medicare prescription drug benefit. Experts had warned that many of the 6.4 million low-income people who get benefits from Medicare and Medicaid could miss out on their life-sustaining medicines when their drug coverage shifted on Jan. 1 from Medicaid to private plans sponsored by Medicare. In interviews, advocates for the elderly as well as lawmakers and seniors themselves indicated that that's happening. Some, such as Deborah King of New York, were placed automatically in new drug plans that don't cover their medications. Others were getting stuck with extra out-of-pocket fees because their new enrollment status couldn't be verified. Medicare's contingency plan for patients who aren't enrolled in drug plans also is proving pro

I finally am going to have my say of something that has been nagging at me for months.I have many friends and readers in the medical profession. I have family members who are physicians, but I am sick of all the put down about "Medicare" recipients actually being supported by taxpayers...This is not directed at the medical profession on the whole, just the ones (few) that seem to really not give us a break at all. I worry that there are educated, intelligent folks out there, who have no understanding of how medicare actually works.I'm not talking here about medical reimbursement for providers. If what I hear is true then what providers get reimbursed is a crock, and only getting worse. But, I want to talk about this misconception, that medicare is handed out to freeloaders and we are being supported by others.I began my journey into the work force in 1968, when I was 16 years old. I went to work after school and on weekends. From that year, until I retired, due to disability in 2004,

Oscar writes: My wife owns a small home-daycare, never more than 15 children. She operates out of our house. She has one full-time (employee) for whom she pays all taxes and medicare and two other part-time contract employees. Her business is legally registered as an LLC partnership. One of the part-time contract employees is demanding that my wife pay SS and Medicare because her tax

Medicare May Help Seniors Stop SmokingDec. 30, 2005 - The public comment period is now open on a new proposal by Medicare to provide new coverage allowing certain senior citizens covered by Medicare who smoke to receive counseling services that will help them quit the habit.

It’s February again, and the millions of Americans who are currently on Medicare know what this season means: the time for open enrollment is quickly running out. Starting each year on November 15 and running through March 31, open enrollment gives individuals currently on Medicare the opportunity to change their Medicare coverage to either Original Medicare [...]