medicare beneficiaries
Home care model growing popular
A California company is quickly becoming one of the leaders in a new--and some say, critically important--care delivery niche. Care Level Management, of Woodland Hills, CA, cares for chronically ill patients in their homes rather than making them come to a physician's office. The idea is to head off potentially serious and expensive complications which would otherwise put them in the hospital. Care Level's primary client is CMS, which is paying Care Level a monthly case stipend and fee …
... Read more...CMS hopes to close Medicare race, ethnicity gap
While anyone would argue that Medicare beneficiaries ought to the get the appropriate level of care regardless of their race or ethnic background, officials with Medicare aren't sure how to make this happen, according to experts addressing a Congressional briefing session this week. Right now, disparities definitely exist in how well minorities are cared for, both within and …
... Read more...Wal-Mart keeps expanding $4 generics rollout
Wal-Mart's $4 generics juggernaut just keeps on rolling. Wal-Mart announced today that it would roll out its $4 generics program to 11 more states, bringing the total to 38, while adding 17 more generics to the program. The retail giant has added Idaho, Kentucky, Maine, Massachusetts, Nebraska, Oklahoma, Rhode Island, South Carolina, Utah, Washington and West Virginia to the list of states …
... Read more...ALSO NOTED: Feds battle to get back Medicare refunds; TN Medicare plan sets $300M IPO; and much more...
> A new study by the Government Accountability Office has concluded that the systems used by CMS to send and receive bills and communicate with providers are riddled with at least 47 security gaps. Report
> The feds haven't given up on getting back at least part of the $50 million in refunds they sent out to 230,000 Medicare beneficiaries. …
... Read more...CMS's $50M mistake
A "data processing error" at CMS has caused the agency to incorrectly refund 231,000 Medicare recipients a total of $50 million. The recipients were mistakenly repaid an average of $215 for several months' worth of their prescription drug coverage. But no worries, the government assured recipients that it would be getting that money back. Medicare beneficiaries were also mistakenly told that Medicare would no longer automatically deduct their prescription drug premiums from their Social …
... Read more...ALSO NOTED: Disease management successful for diabetes; UnitedHealthcare, hospitals may split; and much more...
> In Singapore, a program designed to promote disease management has proved very successful for those with diabetes. Article
> UnitedHealthcare may drop Florida's Blake Medical Center and Doctors Hospital of Sarasota from their plan if the hospitals and the insurer can't agree on a contract before August 29. …
... Read more...CMS to fund program for at-home care
The Wall Street Journal is reporting that the federal government will announce a $1.75 billion program designed to give some Medicare beneficiaries at-home care rather than treating treatment in nursing homes. Long-term care makes up a third of all Medicaid spending and home-based care often costs less than putting a patient in a nursing home. The CMS funding will cover all expenses incurred in the first year by beneficiaries moving to home care. After that, states will receive …
... Read more...Reimbursement rates don't impact MD access
A long-running concern of Congress, analysts and physician groups is that decreased Medicare reimbursements will prevent physicians from accepting Medicare beneficiaries. The concern came to the forefront in 2002 when fees were reduced by 5.4 percent and have continued as healthcare costs outpace reimbursement rates.
Now a GAO report finds that reimbursement has little impact on beneficiaries' access to doctors. The report asked beneficiaries whether or not they had difficulty …
... Read more...Medicare to offer CDHPs in 2007
In yet another sign that consumer-driven health plans (CDHPs) are here to stay, CMS has announced that the plans will be available through Medicare in 2007. The CDHPs will be used in conjunction with medical savings accounts (MSAs) that are similar to health savings accounts (HSAs) but allow beneficiaries more flexibility. The program is designed to protect Medicare recipients from catastrophic costs and lower premiums. Medicare will even cover the amount below the deductible by …
... Read more...GAO finds Part D info inaccurate
Investigators for the Government Accountability Office have found that companies that offer drug coverage to Medicare beneficiaries often provide inaccurate or incomplete data. This is important because the premise of Part D is that out of dozens of plans, patients will choose the one that best fits their needs. But this isn't possible if they're receiving inaccurate data. The GAO also found that customer service reps often misquoted how much the plan would cost annually and that …
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