Many Medicare beneficiaries are elderly and most of them will likely have trouble understanding the complicated new drug plan because of age-related cognitive impairments. As a result, long term care providers will need to educate patients about the new plan, which some predict will prove burdensome. Several long term care association members expressed their concerns in this Dallas Morning News article (free registration): The American Health Care Association, which represents … [Read more...] about Long Term Care Associations Speak Out
Medicare’s New Prescription Drug Plan Causing Confusion
Under Medicare's new prescription drug plan, which goes into effect in January 2006, beneficiaries will have to choose between the new plan and free meds offered by private drug companies. These and other aspects of the program are causing confusion among seniors and industry experts. For example, the program won't be administered by the Social Security Administration, which oversees hospitalization and doctors fees under Medicare. Private insurance companies will manage the plan. … [Read more...] about Medicare’s New Prescription Drug Plan Causing Confusion
Home Health Care Providers Can Expect $370 million in 2006
The Centers for Medicare and Medicaid Services (CMS) has announced that Medicare payments to home health agencies will increase by 2.8 percent next year. Home health care providers, paid through a prospective payment system, can expect $370 million in payments in 2006. How are payment rates calculated? From the CMS web site: Home health payment rates are updated annually by either the full home health market basket percentage, or by the home health market basket percentage as adjusted … [Read more...] about Home Health Care Providers Can Expect $370 million in 2006
Capped Rental Option For Medical Equipment Eliminated
A few days ago I wrote about the Senate's budget bill, which will reduce Medicare and Medicaid spending by $10 billion over five years. According to Medical News Today, the bill will also eliminate Medicare beneficiaries' choice of continuing to rent medical equipment in the capped rental category because a section of the legislation would discontinue that option. How does this effect providers? If Medicare beneficiaries have to pay to maintain the equipment, providers can no longer offer … [Read more...] about Capped Rental Option For Medical Equipment Eliminated
New Medicare Drug Program vs. Free Meds
Medicare beneficiaries may have to choose between the new prescription drug program or free medication from drug companies. I recently wrote about Medicare's new prescription drug program, which goes into effect in January 2006. From the New York Times (registration required): Mr. Bach, 65, who is blind, received worrisome news last month from Bristol-Myers Squibb. The free Plavix he gets from the company's charitable foundation will stop if he enrolls in the new Medicare prescription … [Read more...] about New Medicare Drug Program vs. Free Meds
Cutting Medicare and Medicaid–Hurting Only Providers?
Last Tuesday, the Senate Finance Committee approved a bill that would reduce Medicare and Medicaid spending by $10 billion over five years. Exhibiting a stunning lack of knowledge about basic economics, Senate Finance Committee Chairman Charles Grassley, a Republican from Iowa, said the cuts will affect the health industry (including providers), and not the beneficiaries (Reuters). Republicans are looking to cut Medicare and Medicaid spending even more, while Democrats say they're concerned … [Read more...] about Cutting Medicare and Medicaid–Hurting Only Providers?
Star+Plus and Stents
I have two news items to share this morning. Regarding the Star+Plus Program, long term care providers with limited but relevant information about a client (Client Name, Social Security Number, Client Number, Date of Birth) can submit a Medcaid Eligibility Service Authorization Verification (MESAV), and Managed Care information will be available, effective November 4, 2005. As long as Managed Care information on a client (with valid information) exists, MESAV will return Medicaid and … [Read more...] about Star+Plus and Stents
Fighting Medicare Fraud
Starting in January 2006, Medicare will begin offering coverage for prescription drugs, and attempts to defraud the system have already begun. According to the National Consumers League, "con artists" are taking advantage of the plan's choice provision. "Choice can be a very good thing, but crooks are always looking to take advantage of opportunities and might pretend to be from the government or legitimate companies to trick people into handing over their money or personal … [Read more...] about Fighting Medicare Fraud
Arbitration Agreements–Good Case!
The Texas Supreme Court has issued a favorable ruling for Medicare providers who use arbitration agreements. In a case involving a Texas nursing home, the Court ruled that the trial court should have compelled arbitration. You can find the case by clicking here.The Court considered the question as to whether the Federal Arbitration Act should apply in the case or the Texas Arbitration Act. The Texas Act is not as favorable to providers as the Federal Act is because the Texas Act requires that … [Read more...] about Arbitration Agreements–Good Case!
How to Save Medicare? Die Sooner?!
A story in the New York Times proposes that the government consider saving Medicare money by having people die sooner(free subscription required to view):ALTHOUGH Social Security's fiscal direction has taken center stage in Washington of late, Medicare's future financing problems are likely to be much worse. President Bush has asserted that the Medicare Modernization Act, which he signed in 2003, would solve some of those problems - "the logic is irrefutable," he said two months ago. Yet the … [Read more...] about How to Save Medicare? Die Sooner?!
