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Medicare & Medicaid News for Senior Citizens



 

 

Health & Medicine for Senior Citizens

Brief 15-Minute Visits Take a Toll on the Doctor-Patient Relationship

Patients and physicians say they feel the time crunch as never before as doctors rush through appointments as if on roller skates

By Roni Caryn Rabin, KHN
This KHN story was produced in collaboration with USA TODAY

April 21, 2014 - Joan Eisenstodt didn’t have a stopwatch when she went to see an ear-nose-and-throat specialist recently, but she is certain the physician was not in the exam room with her for more than three or four minutes. Read more...

Medicare & Medicaid News

Quality Data on Inpatient Psychiatric Facilities Now Available to Seniors on Hospital Compare

Centers for Medicare & Medicaid Services continues to expand more information for seniors to help choose best medical care

April 18, 2014 – Quality measures from inpatient psychiatric facilities will be publicly reported on Hospital Compare, a consumer-oriented website that provides information on the quality of care hospitals are providing to their patients, according to a news release yesterday by the Centers for Medicare & Medicaid Services (CMS). Read more...

Senior Citizen Politics

Brought to You by Your State Government!

Kansas Governor Asked to Veto Bill Putting State in Charge of Medicare, Medicaid, Their Federal Funds

Wichita Eagle tries to stop this effort it calls a “real and present danger”

April 10, 2014 – Many of America’s senior citizens may not be aware of the threat posed to Medicare and senior health benefits covered by Medicaid and the Affordable Care Are. Much of the attack is happening in states and is below the radar of national media. Actions by Republicans in Kansas provide a clear picture of the danger, as explained in an editorial that appeared this week in the Wichita Eagle. Read more...

Medicare & Medicaid News

Medicare Records on 880,000 Health Care Providers Now Available for Online Download

Gives consumers unprecedented transparency on the medical services physicians provide and how much they are paid

April 9, 2014 – There is a lot more – a whole lot more, actually – information available today to Medicare beneficiaries who want detailed information on 880,000 distinct health care providers who received $77 billion in Medicare payments in 2012, under the Medicare Part B Fee-For-Service program. Read

Medicare & Medicaid News

Anticipated Cut in Medicare Advantage Plan Payments Becomes Marginal Increase by CMS

Health insurance lobby had fought hard to avoid the cut, wanted payments to remain the same

April 7, 2014 - The highly anticipated change for 2015 to the rate paid to private Medicare Advantage Plans was announced today and it has to be viewed as a win for the health insurance lobby. The proposed rate reduction of 1.9 percent proposed in February by the Centers for Medicare and Medicaid Services became a marginal increase of .04 percent for next year. Read more...

Medicare and Medicaid News

Decoding the High-Stakes Debate Over Medicare Advantage Cuts

Final 2015 Medicare Advantage rates are expected to be released Monday

By Jay Hancock, KHN Staff Writer

April 7, 2014 - Health insurers often try to influence Washington through quiet persuasion in plush offices. To fight potential government cuts for private Medicare plans, however, they’ve hit the streets. The Obama administration has proposed reducing what insurers collect for Medicare Advantage plans - HMOs and PPOs, mainly - that cover about 15 million seniors. (Regular Medicare, which still covers most seniors, pays doctors and hospitals directly.) Read more...

Medicare & Medicaid News

Medicare Physician Quality Reporting, Use of Electronic Prescribing Show Increases

New report issued today compares participation in 2011 and 2012

April 3, 2014 – Two key programs aimed at improving service to seniors and the disabled in Medicare have shown significant increases, according to the Centers for Medicare & Medicaid Services (CMS). This report, however, just includes data on the increase from 2011 to 2012 in the systems – the Physician Quality Reporting System and Electronic Prescribing (eRx). Read more...

Senior Citizen Politics

Congress Retreats to Temporary Fix to Medicare Doc Payments for 17th Time

Mary Agnes Carey, KHN, and Emily Ehtridge, CQ Roll Call, explain the drama in Health on the Hill

"The American Medical Association is extremely disappointed in today's House action to give up on SGR repeal...

March 28, 2014 - For the 17th time, Congress is on the verge of approving yet another temporary fix to the Medicare physician payment formula, according to Mary Agnes Carey, Kaiser Health News. “Known as the Sustainable Growth Rate, or the SGR, the formula has repeatedly called for cuts in Medicare physician payments, but every time that deadline comes up, Congress comes through with yet another sort term patch,” she says. Read more...

Medicare and Medicaid News

CMS Rules Would Help Protect Seniors When Medicare Advantage Plans Drop Doctors

Proposals follow UnitedHealthcare's decision to drop thousands of doctors from its Medicare Advantage plans

By Susan Jaffe, KHN

This KHN story was produced in collaboration with The Washington Post

March 24, 2014 - Federal officials are considering new Medicare Advantage rules to help protect seniors when insurers make significant reductions to their networks of doctors and other health care providers. The proposals follow UnitedHealthcare's decision to drop thousands of doctors from its Medicare Advantage plans in at least 10 states last fall. Read more...

Medicare & Medicaid News

Hospital Compare Has Lots of Info, Too Similar to Make Easy Decisions

Hospitals nationwide have achieved 98% compliance with reporting data, likely represents a substantial improvement in systems and safety

By Stephanie Stephens, HBNS Contributing Writer

March 22, 2014 - There is good news and not-so-good news about Medicare’s Hospital Compare website, designed to help patients choose hospitals with the best quality rating matching their need. The good news is that an amazing 98 percent of hospitals are participating. On the downside, however, patients can’t distinguish the quality of performance of one hospital from another. Read more...

Medicare & Medicaid News

Medicare, Medicaid Patients Can Receive Palliative Care While Still in Treatment as Test Program

Test program authorized by Obamacare to measure if seniors with deadly illness will choose hospice and curative care

March 20, 2014 - Medicare and Medicaid patients will be allowed to continue receiving medical care for their ailment, while at the same time receiving access to palliative care, in a new initiative that began Tuesday. The Medicare Care Choices Model will test improvements to certain beneficiaries’ quality of life while they are receiving both curative and palliative care, according to information from the Centers for Medicare & Medicaid Services. Read more...

Health & Medicine for Senior Citizens

Colon Cancer Rate Takes Big Drop, Particularly for Senior Citizens

Larger declines among Medicare-eligible seniors likely reflect higher rates of screening because of universal insurance coverage

March 17, 2014–Colon cancer incidence rates have dropped 30 percent in the U.S. in the last 10 years among adults 50 and older due to the widespread uptake of colonoscopy, with the largest decrease being in senior citizens over age 65. Colonoscopy use has almost tripled among adults ages 50 to 75, from 19 percent in 2000 to 55 percent in 2010. Read more...

Medicare and Medicaid News

Can Congress Put an End to Annual Medicare Physician Payment Ritual?

“What isn’t fair, given that we have been dealing with this for more than a decade, is the constant uncertainty and wrangling,” AARP spokesman

By Susan Jaffe, Capsules, The KHN Blog
This story comes from our partner NPR's Shots blog.

March 17, 2014 - Congress is still searching for money to avoid a 24 percent cut in pay for doctors who treat Medicare patients. But seniors are already paying their share of the cost in premiums, as if the pay cut — scheduled to kick in on April 1 — won’t happen. Read more...

Medicare & Medicaid News

Medical and Patient Groups Call for Medicare Coverage of CT Lung Cancer Screening

Lung cancer kills more people each year than breast, colon and prostate cancers combined

March 13, 2014 - Last December, the United States Preventive Services Task Force (USPSTF) recommended screening of adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Today a large number of medical and patient groups called on the Centers for Medicare & Medicaid Services (CMS) to provide Medicare coverage of low-dose computed tomography (LDCT) screening for patients defined in the USPSTF recommendations and others found to be at high-risk of lung cancer. Read more...

Medicare and Medicaid News

Medicare Officials Back Away From Changes to Prescription Drug Plan

By Mary Agnes Carey, Kaiser Health News,
Capsules: The KHN Blog

March 10, 2014 - Facing heavy bipartisan opposition on Capitol Hill as well as from patient groups, businesses, insurers and others, the Centers for Medicare & Medicaid Services said Monday it did not plan to move ahead “at this time” with several proposed changes to the Medicare prescription drug program. Read more...

Medicare and Medicaid News

How Proposed Medicare Part D Changes Are Playing On Capitol Hill

Many considered this a program that didn’t need fixing, Medicare says they want to make it better but there is opposition – see video in story

March 7, 2014 - Officials at the Centers for Medicare & Medicaid Services are proposing to remove some drugs from Medicare’s prescription drug plans and limit how many plans insurers can offer. Mary Agnes Carey, Kaiser Health News, and CQ Roll Call’s Emily Ethridge discuss on this video. Text and an audio link are below. Read more...

Medicare and Medicaid News

Administration Faces Opposition To Changes In Medicare Prescription Drug Program

Officials say they want to help beneficiaries make good choices and save taxpayers money

By Mary Agnes Carey, KHN Staff Writer

March 7, 2014 - Medicare’s prescription drug program was controversial when it arrived, but a decade later it is widely considered to be a Washington success story. Now, though, the Obama administration is proposing a series of significant changes to fix what critics say isn’t broken. Read more...

Medicare & Medicaid News

Medicare Reports One Third of Skilled Nursing Patients Harmed in Treatment; Most Preventable

Medicare’s inspector general of skilled nursing facilities reports nearly 22,000 patients were injured and more than 1,500 died in a single month - a higher rate of medical errors than hospitals.

By Marshall Allen, ProPublica

March 4, 2014 - One-in-three patients in skilled nursing facilities suffered a medication error, infection or some other type of harm related to their treatment, according to a government report released today that underscores the widespread nature of the country’s patient harm problem. Read more...

Medicare and Medicaid News

Impact Of Medicare Advantage Cuts On Seniors Sharply Disputed

Several changes in Medicare for 2015 were announced on Friday by Centers for Medicare & Medicaid Services but headlights are on cuts in funding to MA plans

By Phil Galewitz, KHN Staff Writer

Feb. 24, 2014 - Seniors enrolled in Aetna’s Medicare Advantage plan In Baltimore County, Md., saw their monthly premiums rise from $33 to $51 this year. Enrollees in HealthNow New York, a Medicare HMO in upstate Erie County, saw their premiums jump from zero to $28 a month. The health insurance industry points to these examples as some of the more extreme cases of beneficiaries feeling the sting of federal funding cuts to Medicare Advantage plans that cover nearly 16 million senior citizens. Read more...

Medicare and Medicaid News

Obama Administration Proposes 1.9 Percent Cut in Medicare Advantage Payments

News release by Centers for Medicare & Medicaid Services on several changes for 2015 is published below this news report

By Mary Agnes Carey, KHN Staff Writer

Feb. 24, 2014 - An Obama administration announcement about payment rates for Medicare Advantage plans in 2015 has set off a dispute about how large – or small – the changes really are. Late Friday, the Centers for Medicare & Medicaid Services announced proposed rates that officials said could mean payment reductions of 1.9 percent for the private plans in the program. Read more...

Medicare & Medicaid News

Quality Ratings Added to Physician Compare Website for Medicare, Medicaid Patients

Diabetes and heart disease measures among new quality ratings

Feb. 24, 2014 - The Physician Compare website designed to help Medicare and Medicaid patients make informed choices in finding physicians and other health are professionals, has been enhanced by the addition of quality measures to indicate the performance achieved by hundreds of thousands of these care providers in treating specific conditions. Read more...

Medicare & Medicaid: Marci's Q&A

Medicare Adds New Mental Health Coverage in 2014, Explains Marci’s Medicare Answers

Marci’s February Q&A also has solutions for seniors with new Medicare drug plans in 2014

Feb. 13, 2014 – There is new coverage from Medicare in 2014 for outpatient mental health visits that Marci explains in this February issue of Marci’s Medicare Answers.  Another senior writes in who joined a new Medicare prescription drug plan, only to find a prescription he needs is not covered. Marci has good news on this one, too. Read more...

Medicare & Medicaid News

Last Chance to Disenroll from Medicare Advantage Plan is Valentine’s Day

Special disenrollment period ends but seniors should have details before they cancel

Feb. 13, 2014 - Medicare beneficiaries who are dissatisfied with their Medicare Advantage (Medicare private health) plans, have until Friday, February 14, to disenroll. Beneficiaries have had the opportunity to drop their private plan and enroll in Original Medicare since January 1, when the Medicare Advantage Disenrollment Period (MADP) began, according to the Medicare Rights Center. Read more...

Caregiver & Elder Care News

Seniors Moved from Nursing Homes to Home, Community Care Suffer More Hospitalizations

Long-term care at home meets desires of older patients and can save Medicaid money

Feb. 12, 2014 – What looks like a “win-win” for everyone – senior citizens and the Centers for Medicare & Medicaid Services – is not turning out that way, according to a new study in the online Journal of the American Geriatrics Society. The seniors want to age at home, rather than in nursing homes, which can save money for Medicaid. The problem the study found was that as these older people eligible for Medicaid and Medicare were moved  into community care there was a 40 percent greater risk of "potentially preventable" hospitalizations. Read more...

Medicare & Medicaid News

Readmission Rates Lowest for Medicare Rehab Patients With Lower Joints Replaced

Most likely to be back into rehab within 30 days are those being treated for being weak or feeble says JAMA report that takes look at new CMS quality measure

Feb. 11, 2014 - As part of its effort to emphasize quality care, the Centers for Medicare & Medicaid Services has established readmission rates as a way to measure performance for inpatient rehabilitation facilities. A new study of such readmissions for Medicare fee-for-service patients has found the rate of return to the facility within 30 days is the lowest – 6 percent - for those who had joints replaced in their lower extremities and highest – 20 percent - for those treated for debility (weakness or feebleness). Read more...

Medicare & Medicaid News

Bipartisan Plan Would Shift Medicare’s Doctor Payment System To Reward Quality

Long battle over how Medicare compensates physicians takes a new turn; AMA offers support

By Mary Agnes Carey, KHN Staff Writer

Feb. 6, 2014 - The bipartisan leadership of three Senate and House committees introduced legislation Thursday to overhaul the way Medicare pays physicians. Read more...

Health & Medicine for Senior Citizens

Patients, Caregivers Will Have Direct Access to Lab Test Results Due to New Rule by HHS Agencies

Now patients and their designated care-givers can not only get info from physicians, but also directly from laboratories

Feb. 3, 2014 - Patients or someone they designate will soon have direct access to completed laboratory test reports from the lab performing the test. As part of an ongoing effort to empower patients to be informed partners with their health care providers, the Centers for Medicare & Medicaid Services (CMS) and two other agencies in the Department of Health and Human Services (HHS) joined forces to issue the new rule. Read more...

Medicare & Medicaid News

CMS Slams Door on New Home Health, Ambulance Suppliers in Some Areas to Fight Fraud, Abuse

"...the moratoria put fraudsters on notice that we are using all available tools, including these moratoria, to combat fraud, waste and abuse in our health care programs."

Marilyn Tavenner, CMS Administrator

Patient access uninterrupted in current and new counties in agency’s fraud fighting efforts

Jan. 31, 2014 – The Centers for Medicare & Medicaid Services slammed the door yesterday on the enrollment of new home health agencies or ground ambulance suppliers in several cities and extended for six months the current enrollment moratoria in others as part of its fraud fighting efforts. The moratoria extension and imposition of the new moratoria were announced in a notice issued yesterday in the Federal Register. Read more...

Medicare & Medicaid News

Medicare Achieves Significant Savings, Quality Improvements from Delivery System Initiatives

Medicare Accountable Care Organizations, Pioneer ACOs save $380 million

Jan. 30, 2014 - Today, the Centers for Medicare & Medicaid Services (CMS) released findings on a number of its initiatives to reform the health care delivery system.  These include interim financial results for select Medicare Accountable Care Organization (ACO) initiatives, an in-depth savings analysis for Pioneer ACOs, results from the Physician Group Practice demonstration, and expanded participation in the Bundled Payments for Care Improvement Initiative. Savings from both the Medicare ACOs and Pioneer ACOs exceed $380 million, CMS says. Read more...

Medicare & Medicaid News

Medicare Rights University Launched by Medicare Rights Center

A 'one-of-a-kind' online curriculum for health care and insurance professionals

Jan. 29, 2014 - The Medicare Rights Center today announced the launch of Medicare Rights University (MRU), a web-based curriculum designed to empower any professional to better help their own clients, patients, employees, retirees, and others navigate a multitude of Medicare questions. Read more...

Senior Citizen Politics

Medicare Kept 25 Percent of Part D Contracts Out of Plan Finder Due to Pricing Inaccuracy: GAO Report

Senate Special Committee on Aging requested GAO study the shows Medicare’s watchdog actions

Jan. 17, 2014 - A new Government Accountability Office (GAO) report released last week found that during the first seven months of 2013, 25 percent of Medicare Part D contracts had one or more plans suppressed from Plan Finder, the Medicare website seniors use to choose their drug plans, due to pricing inaccuracy, according to a news release from the Senate Special Committee on Aging. Read more...

Medicare & Medicaid News

Still Crazy After All These Years: Preventive Services Open Door to Healthy Aging for Seniors

Ron Pollack, Executive Director, Families USA

Affordable Care Act (Obamacare) makes getting preventive services easier and easier to afford, yet, less than 50% of seniors are up-to-date

Jan. 17, 2014 - A fun-loving, active couple I know, both of whom are older than 85, recently performed in an hour-long musical production. And they were pretty darn good! They are clearly in love and enjoying life. What are they doing right? They told me that they “take care of themselves.” Nothing magical, and no miracle treatments have extended their golden years. Read more...

Health & Medicine for Senior Citizens

What Does Team-Based Care Mean for Patients? Expanding Rapidly with Push by Medicare

Editor’s Note: There are over 360 Accountable Care Organizations working with Medicare to provide higher-quality coordinated care for seniors. Doctors, hospitals and health care providers establish ACOs to work together to provide better health care, while working to slow the growth of health care cost.

By Jessie Gruman, President, Center for Advancing Health

Jan. 16, 2014 - Have you heard that soon most primary care in the U.S. will be delivered by teams? Yep. Team-based care is one of the characteristics of the patient-centered medical home, a way of organizing the care of patients that allows primary care clinicians to see more patients in a day while at the same time delivering better care. Read more...

Medicare and Medicaid News

Congress About to Change Medicare Payment for Physicians; What It Means for Patients, Docs

After years of yearly political battles over what Medicare should pay doctors, a somewhat permanent fix seems about to win passage in Congress.

By Mary Agnes Carey, KHN Staff Writer

Jan. 16, 2014 - After years of legislative wrangling and last-minute patches, expectations are high among physician groups, lawmakers and Medicare beneficiaries that Congress could act this year to permanently replace the current Medicare physician payment formula. While committees in both chambers have approved their own "doc fix" proposals, the approaches have yet to be reconciled, and none have identified how they would pay for a repeal. Read more...

Senior Citizen Politics

Seniors with Multiple Chronic Conditions to Benefit from Medicare Changes in Bi-Partisan Bill

U.S. Senators, Representatives from both parties introduced today the Better Care, Lower Cost Act - video of news conference in story

Jan. 15, 2014 – Millions of senior citizens in Medicare may the among those to benefit from unusual cooperation between Democrats and Republicans to pass legislation that will, according to the sponsors, provide better care and lower cost for seniors and others covered by Medicare that have multiple chronic conditions. Two U.S. Senators from opposite political parties (Ron Wyden, D-Ore., and Johnny Isakson, R-Ga.) and two House members representing both parties (Erik Paulsen, R-Minn., and Peter Welch, D-Vt.) have joined forces to introduce the Better Care, Lower Cost Act today. Read more...

Health & Medicine for Senior Citizens

Millions of Senior Women at High Risk of Breast Cancer May Get Preventive Drugs Free

Estimates are that over 10 million women in U.S.age  35 to 79 could be eligible for tamoxifen chemoprevention on the basis of their risk factors; Obamacare

By Phil Galewitz, Capsules, Kaiser Health News

Jan. 12, 2014 - Starting next September, women at increased risk for breast cancer will be able to get some drugs shown to help prevent the disease without a co-pay, the Obama administration said Thursday. Read more...

Medicare & Medicaid News

CMS Declares War on Prescription Drug Abuse in Medicare, Focus on Opioid, Acetaminophen Users

Begins with validation and analysis of Part D claims data it receives from Part D sponsors

Jan. 9, 2014 – Prescription drug abuse, even in the Medicare Part D drug program, is a nationwide epidemic, according to the Centers for Medicare and Medicaid Services, which has committed to take the problem seriously and begin actions to protect Medicare beneficiaries and the Medicare Trust fund. Targets include Part D enrollees who use opioid or acetaminophen, to see if they have overutilization issues, and physicians who may over-prescribe. Read more...

Medicare & Medicaid News

Program Changes to Improve Medicare Drug Plans, Advantage Program Proposed by CMS

Wide range of programs will be for next year’s programs; seeks public comment

Jan. 8, 2014 – The Centers for Medicare and Medicaid Services is proposing a new way to identify protected classes of drugs and other changes it says will strengthen protections, improve health care quality and reduce costs for Medicare beneficiaries with private Medicare Advantage (MA) and Part D prescription drug plans in Contract Year (CY) 2015. Read more...

Medicare & Medicaid News

Hospitals Serving Elderly Poor More Likely Penalized by Medicare for Readmissions

Medicare reduces payments to penalizes hospitals with high rates of readmissions for pneumonia, heart attack and heart failure; those serving poorest seniors have higher readmission rates

By Valerie DeBenedette, HBNS Contributing Writer

Jan. 7, 2014 - Hospitals that treat more poor seniors who are on both Medicaid and Medicare tend to have higher rates of readmissions, triggering costly penalties from the Centers for Medicare and Medicaid Services (CMS), finds a new study in Health Services Research. Read more...

Medicare & Medicaid News

New Medicare Data Show 364 Hospitals Have High Rates Of Overall Readmissions

List of hospitals by state with the best and worst readmission rates reported by Medicare

By Jordan Rau, Capsules, Kaiser Health News

Jan. 6, 2014 - Medicare’s new comprehensive measure of hospital readmissions shows that at least 20 percent of the hospitals in Illinois, Maryland, Massachusetts, New Jersey, New York and Rhode Island have higher rates of patients returning than the national average. Read more...

Medicare & Medicaid News

Senior Citizens on Medicare Greatly Affected by Obamacare but Not the Insurance Coverage

Answer to question by Social Security representative not exactly accurate saying people in Medicare ‘not affected by Affordable Care Act’

By Tucker Sutherland, editor, SeniorJournal.com

Jan. 6, 2014 – In this week’s Social Security Q&A by Oscar Garcia, Public Affairs Specialist with the Social Security Administration may leave the wrong impression about the Affordable Care Act (Obamacare) and its impact on seniors and others covered by Medicare. He states, “People who have Medicare coverage are not affected by the Affordable Care Act.” He probably meant to explain they do not get health insurance through the program’s Health Insurance Market Place. This is true but many provisions of the health care program do greatly affect senior citizens in Medicare. Read more...

Health & Medicine for Senior Citizens

Seniors Should Heed Study Showing Electronic Health Records Benefit Patients and Physicians

Majority of physicians said they were alerted to a potential medication error or critical lab value by an electronic health record; one-third say they help spot needed tests; Medicare offers physicians incentive

By Sharyn Alden, HBNS Contributing Writer

Jan. 2, 2014 – Senior citizens – the age group most in need of medical care, often from chronic problems – should check to see if their doctors are using electronic health records (EHRs). It may save their life. A new study in Health Services Research finds nearly three-quarters of physicians using EHRs  in 2011 said there were clinical benefits when patients’ medical histories were kept in digital files. Read more...

Caregiver & Elder Care News

Palliative Care Helps with One Family’s Journey: Medicare Program to Improve Care, Reduce Costs

Palliative care focuses on improving the quality of life for patients with serious illnesses, relieving symptoms, pain and stress - It’s not hospice

By Jenny Gold, KHN Staff Writer

Jan. 2, 2014 - When palliative care specialist Dr. Tim Ihrig crosses the threshold of the Avelleyras home, he steps over a doormat that says, "One nice person and one old grouch live here." It doesn’t take long to figure out who the nice person is. Read more...

Medicare & Medicaid: Marci's Q&A

Medicare to Open Advantage Plan Disenrollment; Other Key Information in Marci’s Medicare Answers

Marci’s Q&A has information about Medicare in the new year that may be critical to some senior citizens: changing back to original Medicare, changes in 2014, getting Extra Help

Dec. 27, 2013 – Although Medicare just closed “Open Enrollment” earlier this month, there is a new “Disenrollment” period about to open, when seniors enrolled in Medicare Advantage can switch to Original Medicare. This and other important information about Medicare in 2014 are explained below in the “Dear Marci” Q&A from the Medicare Rights Center. Read more...

Medicare & Medicaid News

Senators Press Medicare for Answers on Failure to Monitor Doctor Waste in Drug Program

.Senator Tom Carper, D-Del., chairman of the Homeland Security and Governmental Affairs CommitteeEarlier ProPublica report detailed wasteful practices by doctors who routinely give patients pricey name-brand drugs when cheaper generic alternatives are available

by Charles Ornstein and Tracy Weber, ProPublica

Dec. 26, 2013 - A Senate committee chairman said he is concerned about the “serious vulnerabilities” detailed in a ProPublica report  about scams that target Medicare’s popular prescription drug program. Read more...

Medicare & Medicaid News

Medicare, Other Health Care Spending Slowing but Cost Controls Must Be Implemented

New England Journal of Medicine study finds health spending rose just 0.8% per person in 2012, Affordable Care Act measures to control costs may be contributing to biggest slowdown in decades

Dec. 26, 2013 – The growth of health care cost is slowing and at least a portion is due to actions stemming from Obamacare (Affordable Care Act), but regardless of the causes, the U.S. needs to try to control health spending. An analysis, published today in the New England Journal of Medicine, also finds that a broad, bipartisan consensus about strategies that will be effective in controlling costs has emerged. Read more...

Medicare & Medicaid News

Does Cataract Surgery Need Preoperative Consultation? It is Increasing for Medicare Patients

Cataract View

Older patients (75 to 84) were more likely to have a consultation than patients age 66 to 74

Dec. 23, 2013 – Cataract surgery – a low-risk surgery that has almost become routine for senior citizens – has increasingly involved a preoperative consultation for Medicare patients, despite no clear guidelines about when to require such a service. A new study suggests in may be unnecessary use of Medicare health care resources. Read more...

Medicare & Medicaid News

Medicare’s Accountable Care Organizations Continue Growth as Health Care Spending Slows

123 new ACOs join program; Congressional Budget Office estimates Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade

Dec. 23, 2013 – There are now more than 360 Accountable Care Organizations working with Medicare to provide higher-quality coordinated care to 5.3 million seniors and other beneficiaries, while reducing the cost of health care, according to an announcement today by HHS Secretary Kathleen Sebelius. And, she added that Medicare is expected to break a decades old pattern of spending growth outstripping economic growth. Read more...

Medicare & Medicaid News

Free Preventive Services Draws Over 25 Million Seniors, Others in Original Medicare

CMS credits Affordable Care Act for accomplishment in first 11 months of 2013; 3.5 million received free Annual Wellness Visit

Dec. 17, 2013 - More than 25.4 million senior citizens and othrs covered by Original Medicare received at least one preventive service at no cost to them during the first eleven months of 2013, because of the Affordable Care Act. Today’s news from the Centers for Medicare & Medicaid Services comes after last month’s announcement showing that the health care law also saved seniors $8.9 billion on their prescription drugs since the law’s enactment. Read more...

Medicare and Medicaid News

Medicare Identifies 97 Best and 95 Worst Hospitals for Hip And Knee Replacements

Latest part of the government’s push to improve quality at the nation’s hospitals instead of simply paying Medicare patients’ bills

By Jordan Rau, KHN Staff Writer

Dec. 17, 2013 - Medicare has begun tracking the outcomes of hip and knee replacement surgeries, identifying 95 hospitals where elderly patients were more likely to suffer significant setbacks. The government also named 97 hospitals where patients tended to have the smoothest recoveries. Read more...

Medicare & Medicaid News

What Senior Citizens Need to Know About Medicare in 2014

Families USA presents a Q&A on information seniors need to know about Medicare in 2014

Dec. 16, 2013 - Many seniors are now looking to Medicare decisions and options for 2014, since open enrollment has closed. Families USA has provided answers to questions they anticipate will be on the minds of senior citizens in the new year. It also has advice for newcomers to the program in the column below. Read more...

Medicare & Medicaid News

Medicare's Hospital Compare Introduces Information on Deadly Hospital Infections

CDC, CMS collaborate to advance public reporting of important hospital quality indicators deadly diarrhea and MRSA - see guide for finding info

Dec. 13, 2013 - Senior citizens, the most regular hospital patients, have long wanted more information about deadly infections that have been occurring to frequently in hospitals. Yesterday, the Medicare website Hospital Compare provided the first look at how their local hospitals are doing at preventing Clostridium difficile infections (deadly diarrhea) and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections. Read more...

Senior Citizen Politics

Congress Moves Closer To Changing How Medicare Pays Doctors

Annual battle over how much physicians will be paid for treating Medicare patients may be coming to and end, as well as worry by seniors if their doctor will still take Medicare patients

Dec. 13, 2013 – Almost as regular as Christmas in December of the last few years has been the congressional battle over how much physicians will be paid by Medicare. Long-standing legislation cut the pay each year and the doctors would have to spend heavily to convince Congress to give them a slight increase. But key House and Senate committees approved legislation Thursday to repeal the Sustainable Growth Rate, the formula officials use to pay doctors who treat Medicare patients. KHN’s Mary Agnes Carey and Politico Pro’s Jennifer Haberkorn discuss below. Read more...

Medicare and Medicaid News

Fewer Medicare Patients Return to Hospital in First Year of Medicare Penalties

Medicare targeting rehospitalizations as a significant indicator of gaps in medical quality in the nation’s hospitals

By Jordan Rau, Kaiser Health News Blog

Dec. 9, 2013 - During the first eight months of this year, fewer than 18 percent of Medicare patients ended up back in the hospital within a month of discharge, the lowest rate in years, the government reported Friday. This drop occurred during the first year that Medicare financially penalized hospitals for their readmission rates, and the government seized on the decrease as evidence the incentives are having an effect. Read more...

Senior Citizen Politics

Protect Low-Income People with Medicare Urged by Aging, Disability, Faith-Based Groups

60 organizations call for Congress to make Medicare QI Program permanent

Dec. 9, 2013The National Council on Aging (NCOA) and 59 other diverse national organizations are urging Congress to make the low-income Medicare Qualified Individual (QI) program permanent as part of the Medicare physician payment (SGR) bill, scheduled to be considered by the Senate Finance and House Ways and Means Committees this week. Read more...

Medicare and Medicaid News

Judge Stops UnitedHealthcare from Dropping Physicians from Medicare Advantage Plan

Judge's order stopping last minute changes by Medicare Advantage plan in Connecticut could have national impact

By Susan Jaffe, Kaiser Health News

Dec. 6, 2013 - In a decision that could have national implications, a federal judge in Connecticut blocked UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state. The Medicare deadline for enrolling in new plans ends tomorrow, leaving little time for seniors to find plans which include their preferred physicians or switch to traditional Medicare. Read more...

Medicare and Medicaid News

Medicare Seeks To Curb Spending On Post-Hospital Care That Varies Widely

Study shows cost of care after leaving the hospital varies widely; Over 25% of Medicare spending in Louisiana, Texas, Mississippi, Oklahoma and Massachusetts for post-acute care – check your state

By Jordan Rau, KHN Staff Writer

Dec. 2, 2013 - After years of trying to clamp down on hospital spending, the federal government wants to get control over what Medicare spends on nursing homes, home health services and other medical care typically provided to patients after they have left the hospital. Read more...

Medicare & Medicaid News

Medicare Saving Big Bucks for Seniors and Taxpayers, Says CMS

News on Obamacare savings on prescription drugs for seniors; new information shows historically low growth in Medicare spending; open enrollment almost over

Nov. 26, 2013 – The Affordable Care Act (Obamacare) may be having problems kicking off the health care exchanges for younger Americans, but for seniors it has saved billions of dollars, according to news today from the Centers for Medicare & Medicaid Services. And, the agency adds, it has reached historically low levels of growth in Medicare spending. Read

Senior Citizen Alerts

Tips for Senior Citizens to Protect Against Health Care Scams

Scammers are trying to con seniors into giving out sensitive information while signing them up for plans they do not need

Nov. 21, 2013 - Fraudsters are capitalizing on the rollout of the Affordable Care Act (ACA) and Medicare’s Open Enrollment. The shifts in the healthcare landscape have prompted some criminals to carry out health care scams targeting seniors, according to the Senate Special Committee on Aging. Read more...

Medicare & Medicaid News

Medicare's Failure to Track Doctors Wastes Billions on Name-Brand Drugs

Investigative reporters with ProPublica found over $300 million was paid in 2011 due to only 913 doctors choosing name brand drugs - see video

by Charles Ornstein, Tracy Weber and Jennifer LaFleur, ProPublica

Nov. 20, 2013 - Medicare is wasting hundreds of millions of dollars a year by failing to rein in doctors who routinely give patients pricey name-brand drugs when cheaper generic alternatives are available. ProPublica analyzed the prescribing habits of 1.6 million practitioners nationwide and found that a tiny fraction of them are having an outsized impact on spending in Medicare's massive drug program. Read more...

Medicare & Medicaid News

Report Finds Rapid Growth in Medicare Observation Services that Can Cost Seniors

Raises concerns about clinical benefit and out-of-pocket costs for seniors, quality of care

Nov. 14, 2013 – AARP Public Policy Institute released a new report today examining the use of hospital "observation status" for Medicare patients. Hospital emergency rooms sometimes hold patients for observation before admitting them or sending them home. This observation status has grown rapidly and for Medicare patients the distinction is important because it can affect out-of-pocket costs. Use of observation status as a substitute for admission also raises concerns about quality of care. Read more...

Medicare and Medicaid News

Obamacare Enrolls About 91,000 in Medicaid As Result of ‘Woodwork’ Effect

Medicaid popular even in states hostile to the Affordable Care Act, like Florida and Texas

By Phil Galewitz, The KHN Blog

Nov. 14, 2013 - Supporters and opponents of the federal health law still can’t decide whether to call it the “woodwork” or “welcome mat” effect — the millions of people currently eligible for Medicaid who are not enrolled and who are expected to sign up as a result of the Affordable Care Act. Read more...

Medicare News

Strange Pricing Details Can Bedevil Medicare Beneficiaries Choosing Drug Plans

Medicare advocates urge seniors to compare plans each year to find a way to save money, but many find the process so complex that they don’t switch

By Susan Jaffe, The KHN Blog

Nov. 13, 2013 - Pharmacist Gina Upchurch knows all the ins and outs of the Medicare prescription drug benefit and was sure she discovered something very wrong:  using the government’s online plan finder tool to help seniors compare dozens of 2014 drug policies, she noticed that some insurers charge higher prices for a prescription filled every two or three months compared to the same drug bought every month. Read more...

Features for Senior Citizens

Where Senior Veterans Get Health Care and More About U.S. Military Veterans on Their Day in 2013

Military veterans honored today with parades and speeches across the nation, national ceremony at the Tomb of the Unknowns at Arlington National Cemetery in Virginia

Nov. 11, 2013 - A hot topic on this Veterans Day is health care. Where to vets who are senior citizens get their health care? The number of veterans age 65 and over covered by Medicare; 4.1 million covered by employer-sponsored health insurance; 3.1 million covered by VA health care; 3.1 million covered by direct-purchase insurance; 1.3 million covered by TRICARE; and 878,00 covered by Medicaid. These numbers are not mutually exclusive. Individuals can have more than one type of health insurance coverage. Read more...

Medicare & Medicaid News

Fighting Medicaid Fraud, Waste, and Abuse Through Education - Medicare Blog

By Ted Doolittle, CMS Deputy Director, Center for Program Integrity

Nov. 7, 2013 - The Centers for Medicare & Medicaid Services (CMS) wants everyone to join in the fight against fraud, waste, and abuse as part of our comprehensive strategy to protect federal health care programs and taxpayer dollars.  We are now making it easier than ever before for health care providers, managed care plans, and individuals and families with Medicaid benefits to use the education and training materials on the new Medicaid Program Integrity website. Read more...

Medicaid News

Medicaid Enrollment is Soaring with Obamacare

Biggest reason for initial jump in Medicaid enrollment is that hundreds of thousands in expansion states have been pre-qualified for expanded Medicaid - see state-by-state report

By Christine Vestal, Stateline

Nov. 7, 2013 - States are reporting far higher enrollment in Medicaid than in private insurance since the Affordable Care Act exchanges opened Oct. 1. In Maryland, for example, the number of newly eligible Medicaid enrollees is more than 25 times the number of people signed up for private coverage. Read more...

Medicare/Medicaid News

Key Senate, House Committee Chairmen Offer Plan To Fix Medicare Doctor Payments

Medicare physician payments will reduce by nearly 25 percent on Jan. 1 unless Congress intervenes; possible end to annual dilemma

By Mary Agnes Carey, KHN Staff Writer

Nov. 5, 2013 - The Democratic and Republican leaders of two key congressional committees have agreed on a framework to scrap the problematic Medicare payment formula for physicians and replace it with one that would link physician reimbursement to the quality of care provided, a step that could put an end to the annual "doc fix" debate. Read more...

Medicare & Medicaid News

Seniors Have More Reasons to Switch Medicare Prescription Drug Plans, Consultant Says

Editor’s Note: The window is open at Medicare for seniors to change the way they receive benefits in 2014 (open through Dec. 7). Most of the attention is focused on the Part D prescription drug plans, which tend to change – some drastically – from year to year. Below is an analysis provided by Allsup, a company that markets health plan consulting advice.

Nov. 4, 2013―A number of changes affecting prescription drug Part D plans signal important reasons for seniors and people with disabilities relying on Medicare to review coverage during the annual open enrollment, according to Allsup, a nationwide provider of Medicare plan selection services. Read more...

Medicare & Medicaid News

No Increase in Cost of Medicare Part B in 2014; More Savings in Drug Program

CMS says major savings for Medicare beneficiaries next year; good news for seniors facing small Social Security increase

Oct. 28, 2013 – Senior citizens facing a projected small increase in Social Security for next year got some good news today from the Centers for Medicare & Medicaid Services. CMS says that health care reform efforts are eliciting significant out-of-pocket savings for Medicare beneficiaries, pointing to zero growth in 2014 Medicare Part B premiums and deductibles, and more than $8 billion in cumulative savings in the prescription drug coverage gap known as the “donut hole.”  Read more...

Medicare/Medicaid News

Seniors Cautioned To Pay Close Attention To Details As Enrollment Begins In Medicare Plans

There’s a likely payoff for those who pay close attention to the details - enrollment open through December 7

By Susan Jaffe, Kaiser Health News

Oct. 16, 2013 - The seven-week enrollment period for next year’s Medicare prescription drug and managed-care plans began Tuesday, but seniors shouldn’t simply renew their policies and assume the current coverage will stay the same.  There’s a likely payoff for those who pay close attention to the details. Read more...

Medicare & Medicaid News

Medicare Opens Enrollment for 2014 Plans, Says Plan Prices Holding Steady

See video in story on how to use the Medicare Plan Finder to compare available plans, make your selection; lead video about Open Enrollment period

Oct. 15, 2013 - Medicare Open Enrollment opened today, according to an announcement by the Centers for Medicare and Medicaid Services (CMS) which has been dark since the government shutdown resulting from the Republican attack on the Affordable Care Act. The enrollment period will end on December 7. The CMS announcement encourages people with Medicare to review their current health and prescription drug coverage options for 2014 and reminds them this is not part of the Affordable Care Act’s new Health Insurance Marketplace, and people with Medicare do not need to do anything with Marketplace plans. Read more...

Senior Citizen Politics

National Council on Aging Tells Congress to Protect Social Security, Medicare

If Congress fails to increase the debt limit key payments to seniors may not be made

Oct. 14, 2013 – The National Council on Aging (NCOA) joined the Leadership Council of Aging Organizations (LCAO) in strongly urging Congress to end the government shutdown and extend the debt limit to December 2014, without putting at risk the Social Security, Medicare, and other benefits that millions of older Americans need to "stay healthy, independent, and secure." Read more...

Medicare & Medicaid News

Analysis Finds Good News on 2014 Medicare Prescription Drug Premiums

Overall stable or lower cost options available to seniors finds HealthPocket study

Oct. 11, 2013 - In an analysis of Medicare standalone prescription drug plans (Part D) based on data recently released by the Centers for Medicare and Medicaid Services (CMS), HealthPocket found that plans will have a stable average premium of $53.80 for 2014, compared to $53.74 for 2013. The analysis also found that the number of participating plans is consistently high throughout the states, ranging from the high 20s to low 30s. Read more...

Medicare & Medicaid News

Medicare Advantage Plan Out-of-Pocket Caps for 2014 Look Good For Consumers

Drug plans with low cost-sharing limits and no premiums available: HealthPocket

Oct. 11, 2013 - In an analysis of Medicare Advantage plans with a bundled prescription drug benefit (MAPD) based on data recently released by the Centers for Medicare and Medicaid Services, HealthPocket found that many plans for 2014 have substantially lower maximum out-of-pocket caps than the current $6,700 limit for MA plans. Read more...

Medicare & Medicaid News

AARP Offers Tips, Guidance on Choosing Plans During Medicare Open Enrollment

Changes can be made to Medicare plans from October 15 through December 7; Distinction between Medicare and Affordable Care Act open enrollment is important

Oct. 10, 2013 – AARP is offering senior citizens tips on choosing the right plan during the Medicare Open Enrollment period, which opens October 15. The organization is also cautioning those in Medicare to not be confused by the open enrollment for the Affordable Care Act (Obamacare) – senior citizens still get their health insurance at Medicare.gov. Read more...

Health & Medicine for Senior Citizens

Oral Health of Older Americans in 'State of Decay' – New Website to Help Find Care

 ‘Older adults face significant health challenges if their oral health is poor, and there is no coordinated program to help fund necessary services.’

Oct. 10, 2013 - The oral health of older Americans is in a state of decay, according to a new national report released today by Oral Health America (OHA). It finds more than half of the country received a "fair" or "poor" assessment when it comes to minimal standards affecting dental care access for older adults. Read more...

Senior Citizen Politics

Republicans Seem Ready to Shift Fight to Cutting Senior Entitlements

Speaker Boehner says on ABC that the fight in Washington is really about the growth in the senior citizen population… the important goal is reducing entitlement spending; may push for cuts that President Obama earlier suggested

By Tucker Sutherland, editor, SeniorJournal.com

Oct. 6, 2013 – There are many who now say the real target of the Republicans in the current battle in Washington is not really Obamacare, it is entitlements, or, more specifically, Social Security and Medicare. These concerns were heightened today when House Speaker John Boehner said on ABC’s This Week that what is driving the conflict is the growth in the senior citizen population. Read more...

Medicare & Medicaid News

Consumer Reports Ranks, Scores Medicare Advantage, Other Health Plans for 2014

CR finds that higher cost does not mean better care; complete report in magazine, rankings free online, Medicare open enrollment starts October 15

Oct. 5, 2013 – Open enrollment for Medicare opens on October 15 and seniors should be exploring their options in insurance plans for 2014. For the fourth year, Consumer Reports is publishing rankings of hundreds of health insurance plans, including Medicare Advantage plans, and, for the first time, plans available in Obamacare. Among new choices in the health plan are Medicaid HMOs. This is also the first time for the organization to take additional steps to identify plans that both provide high-quality care and avoid costly care. Read more...

Medicare & Medicaid News

Understanding the Difference between Medicare and the Health Insurance Marketplaces

Marketplaces are for people who do not have insurance, people on Medicare are insured by Medicare

By Ron Pollack, Executive Director, Families USA

Ron Pollack, Executive Director, Families USA

Oct. 1, 2013 - If you have Medicare, you may be confused by the buzz surrounding the launch of the new health insurance marketplaces, which are part of the Affordable Care Act (also known as Obamacare). What do these marketplaces mean for you? It’s important to understand that Medicare and the marketplaces are entirely separate. Read more...

Medicare & Medicaid News

Senior Citizens Need to Get Ready for Medicare Open Enrollment

Seniors covered by Medicare do not need to buy health insurance on the Health Insurance Marketplace - Medicare Open Enrollment starts October 15

Oct. 1, 2013 – The timing of the government shutdown - there is no good time – has some direct implications for senior citizens, which are about to begin the annual Open Enrollment period, when those on Medicare can choose new health and drug plans. It opens on October 15 and closes on December 7, but making the right choices means researching what is available this year and making comparisons with your current program. It is critical that the Medicare website be functioning properly before and during this period. Read more...

Senior Citizen Opinions & Analysis

Poor Communication to Senior Citizens About Obamacare May Be Costly Error

Even key news release from Centers for Medicare & Medicaid Services misleads senior citizens – its primary audience

By Tucker Sutherland, editor & publisher, SeniorJournal.com

Oct. 1, 2013 – One of the complaints we hear often is that the Obama Administration has done a poor job of communicating to the public about the Affordable Care Act, also known as Obamacare. We certainly agree with this opinion. The administration continues to not only fail to effectively market the programs benefits, but their poor communications continues to confuse the public and senior citizens in particular. Read more...

Medicare & Medicaid News

Medicare, Other U.S. Health Care Spending to Grow More Slowly in Years Ahead

Despite longer lives, growing senior population; Affordable Care Act constrains fee-for-service and private plan payment growth, says report from Centers for Medicare & Medicaid Services (CMS) Office of the Actuary

Sept. 23, 2013 - Medicare spending between 2015 and 2022 is expected to increase from the annual growth of 4.6 percent estimated for 2012, but it will be well below the previous decade’s 9.3 percent rate of growth as the Affordable Care Act constrains fee-for-service and private plan payment growth, according to a report by from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. The report also says spending growth over the next ten years for all U.S. health care will be modest in comparison to historical trends. Read more...

Medicare/Medicaid News

Seniors on Medicare Don’t Need to Apply to the Health Law Marketplaces

Q&A by Kaiser Health News on what senior citizens need to know about the Affordable Care Act (Obamacare)

By Mary Agnes Carey, KHN Staff Writer

Sept. 23, 2013 - Nearly 50 million Americans are enrolled in Medicare, the federal health insurance program for the elderly and disabled. The 2010 health care law, known as the Affordable Care Act, will make some changes to the program. Here are some answers to frequently asked questions about Medicare and the health law. Read more...

Medicare & Medicaid News

As Medicare Open Enrollment Nears More Seniors Opting for Quality Medicare Advantage Plans

Open enrollment begins October 15 and ends on December 7; period when those in Medicare can choose new health and drug plans

Sept. 19, 2013 - Senior citizens are continuing to choose higher quality Medicare Advantage (MA) plans, according to a news release today from Health and Human Services (HHS) Secretary Kathleen Sebelius. She says for the fourth straight year enrollment in these health care plans is projected to increase. Read more...

Health & Medicine for Senior Citizens

Pay for Performance to Physicians Results in Better Patient Outcomes

Incentives offered a whole health care team did not have significant effect

Sept. 17, 2013 – Just modest monetary incentive paid to individual physicians resulted in a significant 8.36 percent increase in patients whose blood pressure was brought down to desired levels or who received an appropriate medical response when it was found that their blood pressure was uncontrolled. However, incentives to a whole health care team or to the physician plus health care team did not have a significant effect, according to a multi-year study reported in the Journal of the American Medical Association (JAMA). Read more...

Medicare & Medicaid News

Medicare Rights Center Launches New Website

Improved navigation, updates and latest on Medicare changes

Sept 13, 2013 - The Medicare Rights Center, New York, has announced the release of the new medicarerights.org, an overhaul of the organization’s website. They say this will make it easier for beneficiaries, professionals, journalists and others to find answers to Medicare questions. Read more...

Alzheimer's, Dementia & Mental Health

Screening for Minor Memory Problems May Wrongly Label Many with Dementia

Experts gather in New Hampshire today to discuss threat to health, the waste of money by unnecessary care; Medicare covers annual cognitive test in wellness visit

Sept. 10, 2013 – The ongoing debate in medical circles over when people – in particular senior citizens – should be screened for various afflictions has not hit the battle against dementia. A political drive, led by the UK and US, to screen older people for minor memory changes (often called mild cognitive impairment or pre-dementia) is leading to unnecessary investigation and potentially harmful treatment for what is arguably an inevitable consequence of ageing, warn experts on bmj.com today. Read more...

Medicare & Medicaid News

Senior citizens need to know details of how Obamacare affects them; don’t join Marketplace plan

Sen. Nelson posts detailed information on how health care reform impacts senior citizens on Senate Select Committee on Aging website

By Tucker Sutherland, editor, SeniorJournal.com

Sept. 5, 2013 – There is a daily barrage of news and advertising for and against the Affordable Care Act – better known as Obamacare – and it has left many senior citizens confused about what they should be doing. Basically, seniors are not involved in the major provision of the plan, which mandates insurance for all Americans and has established the Health Insurance Marketplace to help them locate plans that meet their needs at the best price possible. Seniors on Medicare, however, already have outstanding insurance coverage and should not enroll in a Marketplace insurance plan. Read more...

Medicare/Medicaid News

Hospital ‘observation’ care bad, costly decision for many seniors on Medicare

Considered by Medicare an outpatient service which means seniors can face higher out-of-pocket expenses and fewer Medicare benefits.

By Susan Jaffe, Kaiser Health News

Sept. 4, 2013 - Some seniors think Medicare made a mistake.  Others are just stunned when they find out that being in a hospital for days doesn't always mean they were actually admitted. Instead, they received observation care, considered by Medicare to be an outpatient service. Read more...

Medicare & Medicaid News

Married Medicare beneficiaries get equal access to nursing homes regardless of sexual orientation

HHS change applies to Medicare Advantage plans; first guidance resulting from Supreme Court’s rejection of Defense of Marriage Act

Sept. 3, 2013 - All Medicare beneficiaries in private Medicare plans will have equal access to coverage in a nursing home where their spouse lives, regardless of their sexual orientation, says a news release issued by Health and Human Services last week. This is the first guidance issued by HHS in response to the recent Supreme Court ruling, which held section 3 of the Defense of Marriage Act unconstitutional. Read more...

Medicare & Medicaid News

Decrease in antipsychotic drugs for dementia patients in nursing homes hailed by CMS

Nursing homes moving toward more patient-center treatment as urged by CMS initiative

Aug. 28, 2013 – The Centers for Medicare & Medicaid Services (CMS) cheered new data showing that nursing homes are moving away from the use of antipsychotic drugs for the treatment of patients with dementia and other behavioral health problems. Instead, they are pursuing more patient-centered treatment. Read more...

Medicare/Medicaid News

HHS wants hospital observations credited toward Medicare nursing home coverage

Seniors kept for observation varies by hospital; Medicare doesn't pay for expensive follow-up nursing home care for observation patients

By Susan Jaffe, KHN

Aug. 1, 2013 - Medicare patients' chances of being admitted to the hospital or kept for observation depend on what hospital they go to - even when their symptoms are the same, notes a federal watchdog agency in a report released Tuesday, which also urges Medicare officials to count those observation visits toward the three-inpatient-day minimum required for nursing home coverage. Read more...

Medicare & Medicaid News

Cost of Medicare drug plans for seniors remains flat for fourth year in a row

Other good news celebrating 48th anniversary of Medicare and Medicaid is Obamacare has saved seniors and other beneficiaries $7 billion in prescription drug cost

July 31, 2013 – Health and Human Services celebrated the 48th anniversary of the signing of Medicare and Medicaid into law with the release of data showing that the average premium for a basic prescription drug plan in 2014 is projected to remain stable, at an estimated $31 per month. Read more...

Medicare/Medicaid News

Medicare Stepping Up Plans for Linking Doctor Pay to Quality of Care Rather Than Quantity

Current system encourages physicians to do more procedures that pushes Medicare cost higher

By Jordan Rau, KHN Staff Writer
This KHN story was produced in collaboration with The Washington Post

July 23, 2013 - Medicare is accelerating plans to peg a portion of doctors’ pay to the quality of their care. The changes would affect nearly 500,000 physicians working in groups. The federal health law requires large physician groups to start getting bonuses or penalties based on their performance by 2015, with all doctors who take Medicare patients phased into the program by 2017. Read more...

Medicare & Medicaid News

Medicare poses key questions for seniors

There are recurring penalties you will have to pay if you don’t sign up for certain types of Medicare coverage when you first become eligible

July 22, 2013 - One of the most important decisions seniors will make is choosing the right Medicare coverage when they become eligible for the federal health insurance program. “Your first year of Medicare eligibility is one of the most critical times because of the variety of choices you have to make and the potential for costly mistakes that may last your lifetime,” said Paula Muschler, manager of the Allsup Medicare Advisor, which helps seniors make Medicare selections. Read more in The Dallas Morning News

Caregiver & Elder Care News

Need to Address Long-Term Care Demands Highlighted in Report by AARP, Others

States struggling with high demand and limited resources to provide non-Medicaid long-term services and supports

July 16, 2013 - A report highlighting the challenges facing states in providing long-term services and supports (LTSS) was released today, just as states begin to implement LTSS options in the Affordable Care Act that increase access to Medicaid home and community based services (HCBS). Most states did not increase funding for non-Medicaid services – including senior centers, information and referral, transportation and caregiver supports, such as those under the Older Americans Act. Read more...

Medicare & Medicaid News

Rates of Major Cardiovascular Procedures Differ for Medicare Advantage, Fee-For-Service Patients

Large study of seniors finds Medicare Advantage patients had lower age, sex, race, and income-adjusted procedure rates for angiography and PCI; wide geographic variation, too – See Video

July 11, 2013 - In a study that included nearly 6 million senior citizens from 12 states in Medicare Advantage or Medicare fee-for-service plans, rates of angiography and percutaneous coronary interventions were significantly lower among Medicare Advantage beneficiaries and geographic variation in procedure rates was substantial for both payment types, according to a study in the July 10 issue of JAMA. Read more...

Medicare News

Federal Judge Says Medicare Patients Do Not Have to Improve to Get Physical Therapy

Center for Medicare Advocacy offers free "self-help" packets for Medicare patients explaining how to challenge a denial of coverage

By Susan Jaffee, Kaiser Health News
This KHN story was produced in collaboration with The Washington Post

June 25, 2013 - For years, seniors in Medicare have been told that if they don't improve when getting physical therapy or other skilled care, that care won't be paid for. No progress, no Medicare coverage - unless the problem got worse, in which case the treatment could resume. Read more...

Senior Citizen Alerts

Hype Begins on Health Insurance Marketplace Which Does Not Apply to Seniors on Medicare

Senior citizens need to be aware that the insurance portion of Obamacare does not apply to them – they stay in Medicare

By Tucker Sutherland, editor, SeniorJournal.com

June 24, 2013 - The educational effort by the Obama administration to introduce the Health Insurance Marketplace – the centerpiece of the Affordable Care Act (Obamacare) – kicked off today. There will be lots of hype on this health insurance part of the plan but senior citizens need to know it does not apply to them. Those age 65 and older will continue their coverage in Medicare and, or Medicaid. Below are some key things seniors need to know. Read more...
Medicare & Medicaid News

Understanding Medicare Premiums; Now Projected to Grow Slower

There are different types of Medicare premiums and you can learn more about them in this Q&A from Families USA

By Ron Pollack, Executive Director, Families USA

June 21, 2013 - At the end of May, the Medicare Trustees reported that Medicare costs are expected to grow more slowly than was previously expected. One of the positive effects of this trend is that Medicare premiums are also expected to increase more slowly. What does that mean for you and your family? Here’s a look at the different types of Medicare premiums. Read more...

Medicare & Medicaid News

Senior Citizens May Soon Get Medicare Health Records on Smartphones, Carry on Doc Visits

Within the next 12 months seniors in Medicare will be able to get the same data on their smartphone their doctors send to each other, one doctor says; check out website of Medicare Blue Button

By Elizabeth Stawicki, Minnesota Public Radio

June 17, 2013 - It's one of those unhappy holiday surprises - a visiting family member gets sick. That happened to Dr. Farzad Mostashari last Thanksgiving. Read more...

Yahoo News

Sequester hits cancer patients — doctors, lawmakers seek fix

By Rachel Rose Hartman, Yahoo! News | The Ticket

June 10, 2013 - You may have heard that White House tours were cut due to across-the-board federal spending cuts known as the sequester. Or that Congress made sure to minimize disruptions to air travel. Or perhaps you know someone being furloughed as a result of the cuts.

But did you know a major fight is being waged over sequester cuts to some cancer drugs?

After Congress failed to pass a budget this spring, a 2 percent cut to Medicare chemotherapy drug reimbursements went into effect April 1 as part of the across-the-board federal spending cuts designed to save $85.4 billion this year. More at Yahoo News

Medicare & Medicaid News

New Medicare Statements in the Mail to Help Seniors Fight Fraud

Redesigned health care summaries designed to help seniors identify improper payments; mailed quarterly

June 10, 2013 – Medicare says senior citizens and other beneficiaries of the program will soon be receiving a redesigned statement of their claims for service and benefits. The new look is aimed at helping them spot “potential fraud, waste and abuse.” Read more...

Medicare & Medicaid News

Administration Says New Data Release Helps Patients, Doctors Improve Health Care

‘...committed to making the health system more transparent and harnessing data to empower consumers’

June 3, 2013 – On the heels of the Medicare Trustees Report saying the life of Medicare has been extended by better control of spending, the Centers for Medicare & Medicaid Services (CMS) and other agencies today released new data making the cost of health care even more transparent for patients and medical professionals. Read more...

Medicare News

Better Control of Spending Extends the Life of Medicare Trust Fund

See below news report: About Trustees Report (Links to detailed information); Summary of 2013 Reports; News Reports by Leading Media

By Mary Agnes Carey, Kaiser Health News

June 3, 2013 - Slower growth in spending is helping extend the life of Medicare’s hospital trust fund to 2026, two years beyond last year’s estimate, officials said Friday. Read more...

Social Security Q&A

How to Fix a Hole in Social Security Work History; Must You Buy Medicare Part A Hospital Insurance?

As more open ‘my Social Security’ accounts there are certain to be more questions for SSA to answer in this weekly Q&A

May 29, 2013 – As more senior citizens and others create personal online accounts at Social Security, there is a natural increase in questions about their records. Oscar Garcia, writing for the SSA Q&A explains what to do if you find part of your work history missing. He also has an answer for a senior wanting to know if they have to buy Medicare Part A – hospital insurance. Read more...

Medicare & Medicaid News

Can Medicare Save Money for Beneficiaries and Taxpayers Alike?

Drug program offers some sizable opportunities for the program and senior citizens to save

By Ron Pollack, Executive Director, Families USA

Health Care Matters

May 28, 2013 - Since Medicare Part D went into effect in 2006, prescription drugs have been an integral part of the Medicare benefit package. So, the question of how seniors can save additional money on medications often comes up, but so does the question of how the entire Medicare Part D program can be more cost-effective and save taxpayers money without jeopardizing enrollee benefits. Read more...

Caregiver & Elder Care News

Health Plan Offers Members Access to Walgreens Clinics; Geriatric Society Offers Tips on Use

AGS updates tip sheet on what senior citizens and caregivers need to know about using retail clinics; Wellcare makes deal for Medicare health plan members

By Tucker Sutherland, editor

May 23, 2013 - Health care services by retail clinics can be a safe option for older adults for occasional, minor health problems, but should not take the place of an individual’s primary care provider, according to a newly updated consumer tip sheet by the American Geriatrics Society (AGS) and Healthinaging.org. A sign of the growing popularity of these clinics is an announcement this week by WellCare Health Plans that it will offer its Medicare Advantage members access to the more than 370 Take Care Clinics located at select Walgreens.

Medicare & Medicaid News

Senate Aging Committee Wants GAO Investigation of Medicare Drug Plan Information; Opens Hearing

'Aggressive marketing tactics used by Medicare Advantage plans may be misleading senior citizens about the true cost and scope of benefits'

May 22, 2013 – The bi-partisan leadership of the Senate Special Committee on Aging has requested an investigation of pricing and coverage details presented by sponsors of Medicare prescription drug programs on Medicare’s online Part D. prescription drug plan finder. The committee will also hold its own hearing today on the Medicare drug program, which is nearing its tenth anniversary. Read more...

Medicare & Medicaid News

Ideas on Cutting Cost of Medicare Released by Medicare Rights Center

Medicare advocate also unveils updated fact sheets on Medicare deficit reduction proposals

May 20, 2013 - The Medicare Rights Center, New York, recently released its latest fact sheet in a series on ways to reduce the Medicare deficit. The latest resource, “Build on What Works: Medicare Cost Savers,” outlines proposals to eliminate wasteful spending in Medicare and promote the delivery of high value, affordable health care. Read more...

Medicare & Medicaid News

Marilyn Tavenner Confirmed to Head Medicare, Medicaid After Six Years of Senate Inaction

Jennifer Haberkorn of Politico Pro discusses the confirmation and the future for the CMS chief in interview with Kaiser Health News

May 16, 2013 – It only took about six and a half years but the Senate has confirmed a chief administrator for the Centers for Medicare and Medicaid Services. Marilyn B. Tavenner, the Obama nominee, got the Senate nod yesterday on a 91-to-7 vote. She has been acting head for two years after serving as Virginia’s health secretary and as a hospital executive. Read more...

Medicare & Medicaid News

New Round of Health Care Innovation Awards Follows Year of Slower Growth in Medicare Costs

Program by Center for Medicare and Medicaid Services seeks more ideas for better health care at lower cost

May 15, 2013 – On the heels of news that healthcare spending by Medicare per beneficiary increased by just 0.4 percent last year – far below historical averages – the Obama administration today announced the second round of Health Care Innovation Awards as part of the effort to deliver better healthcare at a lower cost. Read more...

Medicare News

Wide Variance in What Hospitals Charge Exposed in Data Release by Obama Administration

Consumers don’t know what hospitals charge them or their insurance company; info aimed at helping them make smart choices

May 8, 2013 – The cost of healthcare just became a lot more transparent with the release of information by Health and Human Services on what hospitals charge for common inpatient services. The information shows an extreme variance across the country and even within communities. Read more...

Medicare & Medicaid News

Seniors Stunned by Costly Medicare Rules for Observation Care; Advocates Head to Court

Elderly patient shocked to learn two days of hospital stay were considered 'observation care' and kept her from nursing home coverage

By Susan Jaffe, Kaiser Health News

May 3, 2013 - After Lois Frarie, a 93-year-old retired teacher from Monterey, Calif., spent four days at a local hospital while being treated for a broken elbow and pelvis, she went to a nearby nursing home to build up her strength. But her family was stunned to find out that they would have to pay thousands of dollars up front since two of the days she spent in the hospital were considered "observation care." Read more...

Medicare Seeks To Limit Number Of Senior Citizens Placed In Hospital Observation Care

Statement issued by CMS is below this news story; now elderly must spend three days as hospital patient before being eligible for nursing home care

By Susan Jaffe, Kaiser Health News

May 3, 2013 - Medicare officials have proposed changes in hospital admission rules that they say will curb the rising number of beneficiaries who are placed in observation care but are not admitted, making them ineligible for nursing home coverage. Read more...

Medicare News

Obama Administration Offering Seniors a Reward of Almost $10 Million for Exposing Medicare Fraud

Also funding expansion of Senior Medicare Patrol to spread the word on fraud, waste and abuse - elderly are on  'frontlines of this fight,' 'critical partners' in protecting taxpayer dollars

April 24, 2013 – The Obama Administration made it clear today that it is out to stop Medicare fraud. The proposal of a new rule today indicates they want to increase rewards paid to Medicare beneficiaries and other individuals whose tips about suspected fraud lead to the successful recovery of funds to as high as $9.9 million from the current limit of $1,000. Read more...

Health & Medicine for Senior Citizens

Questions About Colon Screening Coverage Still Vex Consumers; Difference for Medicare, Others

People in group, individual health plans don't pay for polyp removal during a screening colonoscopy; feds say it is an integral part of screening and should be covered without cost sharing - Medicare may still require co-pay. Some remain vexed and confused about testing that begins at age 50 for second leading cancer killer

By Michelle Andrews, Insuring Your Health, KHN

April 16, 2013 - No one looks forward to screening tests for colon and rectal cancers. But under the Affordable Care Act, patients are at least supposed to save on out of-pocket costs for them. Coverage is not always clear, however, and despite the federal government's clarifications, some consumers remain vexed and confused. Read more...

Senior Citizen Politics

Five Ways the President's Budget Would Change Medicare; Reduce Spending $371 Billion in Decade

Wealthier beneficiaries to pay more for coverage and future retirees to pay higher copays for outpatient services such as doctor's visits and home health care

By Mary Agnes Carey, KHN Staff Writer

April 15, 2013 - President Barack Obama's fiscal 2014 budget includes a variety of what he says are "manageable" changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes and other health care providers that serve them. Read more...

Senior Citizen Politics

Ways and Means Draws Bead on Medicare Cuts, Chained CPI to Limit COLA for Social Security

HHS Secretary Sebelius in witness chair today on total budget for HHS, CMS with Social Security proposal the target this Thursday

April 12, 2013 – The Republican-led House Ways and Means Committee has grabbed the lead in questioning President Obama’s 2014 budget proposals for the Department of Health and Human Services, which includes the Centers for Medicare and Medicaid Services. HHS Secretary Kathleen Sebelius will testify there today and next Thursday the hearing topic will be on entitlement reform proposals, with emphasis on the controversial Chained Consumer Price Index, which will be used to lower cost-of-living adjustments for seniors and others in future years. Read more...

Senior Citizen Politics

Obama Says Budget Proposal Offers ‘Manageable’ Curbs on Medicare Cost, Social Security Benefits

Most media reports say focus of White House is to strike a ‘Grand Bargain’ with Republicans who want to change Medicare into a voucher-style system;  Medicare proposal has one revenue item - higher premiums for couples making more than $170,000 a year

April 11, 2013 - The White House says its budget is a good start toward controlling government entitlement programs by offering proposals to curb the growth of Social Security, Medicare and other federal benefit programs. The budget blueprint, released Wednesday, includes what the president called "manageable" curbs on Medicare spending growth, but GOP congressional leaders were dismissive, while some Democrats and virtually all senior citizen advocacy groups were unsettled. Read more...

Senior Citizen Politics

How Chained Consumer Price Index Proposed by Obama Works to Curb Social Security Benefits

Bureau of Labor Statistics provides a Q&A about inflation calculation that will slow cost-of-living adjustments for senior citizens

April 11, 2013 – The term “COLA” is a part of the Social Security program that has been highly cherished by senior citizens. It stands for “cost-of-living adjustment,” and was the government’s way of being trying to keep retired older Americans from seeing their Social Security benefits eaten away by inflation. Now, the Obama administration has come up with a new way to calculate inflation that will reduce COLA in the future. It is called the chained consumer price index and below is a Q&A on this method provided by the Bureau of Labor Statistics. Read more...

Senior Citizen Politics

Reporters Dig Into Obama Budget and Find Other Proposals that May Impact Seniors

More spending on Medicaid, mental health; replacing current formula for Medicare pay to doctors

April 11, 2013 – Senior citizens have – rightly so – primarily focused on the cuts to Social Security and Medicare in the 2014 budget proposal from the White House that was presented yesterday. Media sources have found other parts of the budget that may also impact many seniors - funding boosts for mental health and food and drug safety, as well as the elimination of the SGR formula to set Medicare physician payment rates. It also delays funding cuts to hospitals that treat the uninsured. Read more...

Senior Citizen Politics

Congress Could Lose Older Voters by  Cutting Social Security, Medicare, Vets Benefits: AARP Poll

Senior advocates seem solid in opposition to cuts expected to appear Wednesday in President Obama’s budget; Congressional call-in on Wednesday

April 8, 2013 – Groups that advocate for senior citizens and senior issues appear to be solid in their opposition to budget moves advocated by Republicans and now supported by the White House that will cut income from Social Security and reduce spending by Medicare. A survey released today by AARP says 84% of American voters age 50 and older oppose the chained CPI proposal for reducing Social Security benefits for years ahead. Read more...

Medicare News

Medicare Advantage Plans Win Major Concession from Obama Administration

Payments to insurers was forecast in February to be cut for 2014, but it goes up in revision released Monday

April 2, 2013 – The final rate announcement for Medicare was to be announced yesterday but was a little delayed as the Centers for Medicare & Medicaid carefully worded the news release revealing a 3.3 percent increase for insurance companies offering Medicare Advantage plans, rather than the 2.2 percent reduction forecast in a February announcement. Read more...

Medicaid News

Arkansas Medicaid Plan, Born Of Necessity, Shakes Things Up in Reluctant Republican States

By Karl Eisenhower, Capsules – the KHN Blog

 March 26, 2013 - Since the Supreme Court made the Medicaid expansion under the federal health law optional last year, states’ decisions have largely split along party lines. States run by Democrats have been opting in; states run by Republicans have mostly been saying no or holding back.. Read more...

Medicare News

Medicare a Hot Button as Budget Proposals from Political Parties Smash Head-On

GOP’S Ryan presents ‘austere budget proposal that looks a lot like one they approved last year that Democrats quickly dismissed. Republicans revived plans to overhaul Medicare, slash the social safety net for the poor and bolster defense — all while lowering corporate and individual tax rates to no more than 25%’

March 13, 2013 – The political parties are running out their budget proposals and the general consensus is they are “miles apart.” The House GOP plan, which was unveiled yesterday, would repeal the health law's subsidized insurance exchanges and Medicaid expansion and turn Medicare into a premium-support system. The Senate Democrats' plan, scheduled for release today, would lower domestic spending in part by saving $275 billion through changes to Medicare and Medicaid that are smaller than those proposed by Republicans. Read more...

Senior Citizen Politics

Senate Aging Committee Hears Changes to Medicare Unpopular with Senior Citizens, Voters

First hearing of this Congress lays out the problems and the options with a focus on fixing the cost of healthcare

Feb. 28, 2013 - The first hearing by the Senate Special Committee on Aging since the leadership was handed to Sen. Bill Nelson (D-Fl) and ranking member, Susan Collins of (R-Me) took on the challenge of Medicare’s future yesterday. But, rather than a doom-and-gloom hand wringing, it was an earnest, straight-forward approach at helping the popular senior program survive with little or no damage to its services. Read more...

Senior Citizen Politics

Chairman

Bill Nelson

New Senate Aging Committee Tackles Future of Medicare in Hearing Wednesday

Sen. Bill Nelson (D-Fl) takes over as chairman; Sen. Susan Collins (R-Me) now leads Republicans (see members below news story)

Feb. 26, 2013 – The first hearing by the Senate Special Committee on Aging will convene tomorrow in hopes of finding the best way to shape the future of Medicare to meet the challenges of a booming senior population, climbing prices for health care and a strained federal budget. It is the first hearing under new chairman, Sen. Bill Nelson (D-Fl), and ranking member, Sen. Susan M. Collins (R-Me). Read more...

Medicare News

Changes To Medicare is Focus of Three Congressional Hearings This Week

Small signs that Democrats and Republicans are beginning to wrestle with the issue of what role Medicare should play in deficit reduction

By Mary Agnes Carey

Feb. 25, 2013 - With $85 billion in automatic federal spending cuts set to take effect on Friday and predictions of economic disruption, much of official Washington is focused on the “blame game.” Publicly, there has been no sign that Congress or administration officials has made any progress on averting these cuts or finding common ground on tackling the country’s fiscal problems. Read more...

Medicare News

Traditional Medicare’s Administrative Cost – 1%; Private Company Medicare Advantage – 6%

Setting the record straight on Medicare's overhead costs: New study finds surprising results

Feb. 20, 2013 - The traditional Medicare program allocates only 1 percent of total spending to overhead compared with 6 percent when the privatized portion of Medicare, known as Medicare Advantage, is included, according to a study in the June 2013 issue of the Journal of Health Politics, Policy and Law. Read more...

Medicare News

Seniors to See Lower Costs in Medicare Drug, Advantage Plans in 2014, Says CMS

Agency also says seniors getting greater value and improved payment accuracy in proposed 2014 payment and policy updates

Feb. 16 , 2013 – Medicare costs for seniors are going down, says an announcement yesterday by the Centers for Medicare & Medicaid Services. Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment is expected to increase by an estimated 28 percent through this year. In addition, costs of the defined standard Part D plan will be lower in 2014 than they are in 2013. The standard Part D deductible will be $310, down from $325 in 2013, and cost-sharing amounts will also be lower. Read more...

Senior Citizen Politics

President Obama Calls For Two 'Modest Reforms' To Medicare

Obama suggests two specific changes in Medicare: drug-makers should go back to giving rebates for dual-eligibles, having wealthiest seniors pay more for Medicare

Feb. 14, 2013 - Jackie Judd and Kaiser Health New's Mary Agnes Carey examine the health care issues in Tuesday night's State of the Union address - and Sen. Rubio's Republican response - in this Health on the Hill discussion. Read more...

Medicare News

Medicare Says Obamacare Provided $5.7 Billion in Drug Savings; Free Preventive Service to 34 Million

Detailed reports shows state-by-state activity; emphasizes donut hole reduction, free preventive services, holding down costs, stopping fraud

Feb. 7, 2013 – A detailed report of the savings and benefits enjoyed by senior citizens in Medicare, since the passage of the Affordable Care Act (Obamacare), was released today by the Centers for Medicare and Medicaid Services. It highlights the $5.7 billion seniors saved by the shrinkage of the drug programs “donut hole,” the 34 million older Americans who have used a free preventive health service, program costs control and fight against fraud. Read more...

Senior Citizen Politics

Obama Says He Has Offered 'Sensible Reforms To Medicare' in Press Briefing on Budget

‘Reforms would reduce our government’s bills by reducing the cost of health care, not shifting all those costs on to middle-class seniors…’ see video

Feb. 6, 2013 – President Barack Obama spoke briefly to the press yesterday about budget negotiations and emphasized the need to reduce the cost of health care in the U.S. He also touched on entitlements and, specifically, Medicare. Below is the complete transcript with key words on senior programs highlighted in yellow. Read more, see video...

Medicare News

Hospice Group Says JAMA Report on Last Minute Use of Hospice Care is Call for Action

NHPCO calls for earlier and more frequent conversations between patients and healthcare professionals

Feb. 6, 2013 – Research published yesterday in JAMA found the rate of hospice use doubled from 2000 to 2009 but 28 percent of these dying Medicare patients used the service three days or less. This is “a call for action,” says a statement from the National Hospice and Palliative Care Organization. Read more...

Medicare News

Lower Percentage of Medicare Patients Dying in Hospitals; Increase in Use of ICUs, Hospice

The use of hospice care has doubled but it tends to be for a very short period before death - see video

Feb. 5, 2013 – In a study that included data on more than 800,000 Medicare patients who died between 2000 - 2009, a lower proportion died in an acute care hospital in recent years, although both intensive care unit (ICU) use and the rate of health care transitions increased during the last month of life, according to a study appearing in the February 6 issue of JAMA. Read more, see video...

Medicaid News

Florida Gets Okay to Shift Medicaid Long-Term Care for Seniors to Managed Care

Medicaid-eligible seniors needing long-term care likely will start enrolling later this year in managed care - in their homes!

By Jim Saunders, The News Service of Florida.

Feb. 5, 2013 - Federal health officials have approved a key part of Florida's effort to transform its Medicaid program, clearing the way for tens of thousands of seniors across the state to move into managed-care plans. Read more...

Medicare News

Sickest Senior Citizens Appear to be Leaving Medicare Advantage for Traditional Medicare

Some question if private HMO-style plans structure care to be less appealing to very ill, want to hold more profitable patients; maybe very sick seniors more interested in choosing doctors

By Jordan Rau, KHN Staff Writer

Feb. 4, 2013 - New research finds that many seniors who switch from their HMO-style Medicare Advantage plan to traditional Medicare have higher levels of significant health problems, fueling concerns that the private plans cater to more profitable, healthy beneficiaries but don’t provide the most attractive care for the very ill. Read more...

Medicare News

Medicare Patients with Heart Failure, Attack, Pneumonia Return to Hospital for New Reasons

Diagnoses associated with 30-day re-admission are diverse and not associated with patient demographics or time after discharge for older patients - see video

Jan. 23, 2013 – Among approximately 3 million Medicare patients hospitalized for heart failure, heart attack, or pneumonia, re-admissions were frequent throughout the 30 days following the hospitalization, and resulted from a wide variety of diagnoses that often differed from the cause of the index hospitalization, according to a study appearing in the January 23/30 issue of the Journal of the American Medical Association (JAMA). Read more, see video...

Medicare News

Medicare Efforts to Slow Hospital Re-Admissions, Hospitalizations Makes Some Gains in Tough Fight

Re-hospitalizations, hospitalizations down but rate of re-admissions to discharges holds steady

Jan. 23, 2013 – A top priority in Medicare’s effort to control cost has been to reduce re-hospitalizations and a new study finds some success. In communities where care transition initiatives were implemented for Medicare patients, there have been declines in all-cause 30-day re-hospitalizations and hospitalizations in general. But, there was no significant drop in the rate of re-hospitalization as a percentage of discharges. Read more...

Medicare News

Hospices May Be Discouraging Patients with Expensive Medical Needs

Medicare pays for most hospice care and a patient's doctor and hospice medical director must certify patient has 6 months or less to live; patients must agree not to seek curative care

Jan. 23, 2013 - Many people who are terminally ill delay entering hospice care until just a few days or weeks before they die, in part because they or their families don't want to admit that there's no hope for a cure. Read more...

Senior Citizen Politics

Senior Citizens Hear Encouraging Words on Entitlements in President's Second Inaugural

'The commitments we make to each other through Medicare and Medicaid and Social Security, these things do not sap our initiative, they strengthen us' - see video

Jan. 22, 2013 – President Barack Obama generally drew praise from senior citizen advocates for the words in his inaugural address yesterday that signaled his commitment to preserve the “entitlement programs” of Medicare, Medicaid and Social Security. Read more, see video...

Medicaid News

HHS Issues Rule to Equip Medicaid, States to Better Handle Influx of New Medicaid Patients

Hopes to streamline eligibility, appeals and give states more flexibility as millions more join Medicaid, Children’s Health Insurance Program

Jan. 14, 2013 – Medicaid is headed for significant expansion in 2014 due to the Affordable Care Act, and Health and Human Services proposed a rule today to promote consistent policies and processes for eligibility notices and appeals in this program, the Children’s Health Insurance Program (CHIP) and state-based health insurance marketplaces known as Exchanges. Read more...


 

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