IMPORTANT NOTICE: Many stories
relating to Medicare appear in our section on
Senior Politics. News on the Medicare drug program is in its own
section - Click
Medicare Drug Program News
CMS Says New Regulations Will Better Protect Seniors
in Advantage and Drug Plans
Proposal tightens marketing rules, protects from
inappropriate cost sharing
May 8, 2008 - The Centers for Medicare & Medicaid
Services (CMS) says in a news release today that it will propose new
regulations and new requirements for Medicare Advantage (MA) health
plans and Medicare prescription drug plans. The CMS statement says the
actions will provide "enhanced protections" for senior citizens enrolled
in these plans.
Read
more...
Medicare News
Medicare to Cover Artificial Hearts When Used in FDA
Approved Clinical Research
Decision revises a long-standing non-coverage policy
May 2, 2008 - Medicare should soon start paying for
artificial hearts, at least when they are implanted as part of a study
that is approved by the Food and Drug Administration (FDA) and that
meets CMS’ Coverage with Evidence Development (CED) clinical research
criteria. Read
more...
HHS Secretary Leavitt Urges Lawmakers, Public to
'Start Now' To Make Changes to Medicare
Congress has only three methods -- raising taxes,
reducing benefits or lowering payments to providers
April 30, 2008 - Health and Human Services
Secretary Mike Leavitt said Tuesday that it is "simply unreasonable" to
think Medicare can maintain its solvency without changes to the program
and that if "we start now, the change can be made over time and with
genuine fairness,"
CQ HealthBeat reports.
Read
more...
Senators Compliment CMS on Nursing Website but Push
Bi-Partisan Bill for More Info
Democrat Kohl, Republican Grassley push bill to
expand transparency
April 28, 2008 – Two U.S. Senators from different
parties came together last Friday to compliment the Centers for Medicare
and Medicaid Services for increasing the information available on their
Website, Nursing Home Compare, but they say the agency has a ways to go
to achieve the transparency and information for consumers called for in
the Senate bill they have crafted.
Read
more...
Health Care System Unprepared for Millions of Baby
Boomers About To Become Eligible for Medicare
U.S. would need 36,000 geriatricians by 2030 to meet
the need
April 16, 2008 -The U.S. health care work force is
"too small and woefully unprepared" to meet the geriatric care needs of
the 78 million aging baby boomers, according to a report released on
Monday by the
Institute of
Medicine, the Wall Street Journal reports (Francis/Fuhrmans,
Wall Street Journal, 4/15). The report, titled "Retooling for an Aging
America: Building the Health Care Workforce," estimates that currently
there is one certified geriatrician for every 2,500 seniors.
Read more...
CMS Proposal Says Medicare Won't Pay Hospitals for
Mistakes Like Cutting Off Wrong Leg
Adding 43 new quality measures on which hospitals
have to report data in order to receive full payment for services
April
15, 2008 - The screws are being significantly tightened to improve the
care of Medicare patients in the hospital and to save millions of
dollars for Medicare by not paying for certain conditions - such as
having the wrong leg cut off - that are caused in the hospital. The
Centers for Medicare & Medicaid Services (CMS) on Monday proposed these
additional steps to strengthen this tie between the quality of care
provided to Medicare beneficiaries and payment for the services. Read
more...
Medicare Advantage Plans to Get More Subsidy, Drug
Plans Get Higher Deductible
CMS to pay 3.6% more to MA plans, drug deductible
goes to $295 from $275 in 2009
 Read
complete Fact Sheet below news report. |
April 9, 2008 – The subsidy paid by Medicare to
Medicare Advantage Plans will increase by 2.6% next year, despite
consistent opposition by advocacy groups and Democrats to this subsidy,
according to an a Fast Sheet published by the Centers for Medicare and
Medicaid Services on Monday. And, the drug plan providers also got a
small boost in the form of higher deductibles for prescription drug
plans next year.
Read more...
Hospital
Mistakes Kill 270,491 Medicare Patients in 3 Years, Cost $8.8 Billion
HealthGrades says 238,337 deaths preventable, top
hospitals have 43% lower incident rate
April 8, 2008 – Hospital safety incidents caused the
deaths of 270,491 Medicare patients during the years 2004 through 2006,
according to a new report from HealthGrades, which estimates 238,337 of
these deaths were potentially preventable. There were more than a million
safety incidents during the three years studied.
Read more...
End-of-Life Spending Varies Widely for Medicare
Patients with Chronic Conditions
New Jersey spent most, $59,379; North Dakota least,
$32,523; US average $46,412 - Kaiser Network Daily Report
April 7, 2008- There is wide variation among the
U.S.'s top academic medical centers in spending on care for Medicare
beneficiaries with chronic conditions during the last two years of their
lives, according to the 2008 edition of The Dartmouth Atlas of Health
Care, the
New York Times reports.
Read more...
Medicare Patients Should Expect Better Care at
Dialysis Centers, Says CMS
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5 tips to prevent CKD below |
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CMS issues final rule to update Medicare
‘conditions for coverage’
March 4, 2008 – Senior citizens should expect a
higher quality of care when receiving dialysis, according to an
announcement yesterday from the Centers for Medicare & Medicaid Services
(CMS), that it has released a final rule that will modernize the
Medicare conditions for coverage for the nation’s dialysis centers.
Read more...
Hospital Compare Website Helps Medicare
Beneficiaries Learn More About Local Hospitals
Latest expansion in growing list of consumer Websites
by CMS
March
31, 2008 – For the first time, Medicare consumers have the three
critical elements - quality information, patient satisfaction survey
information, and pricing information for specific procedures - they need
to make effective decisions about the quality and value of the health
care available to them through local hospitals, according to the Centers
for Medicare & Medicaid Services (CMS), which announced changes to the Hospital
Compare Website, one of several by CMS to help consumers make
intelligent health care choices.
Read more...
New Trustees Report Says Medicare Going Broke
Slightly Faster than Expected
‘We need to act quickly and effectively to address
Medicare’s fiscal health’ HHS Secretary
| |
>> Read report by
KaiserNetwork.org below main story. |
|
March 26, 2008 – As many have long known, Medicare
is under a great deal more financial stress than the Social Security
program, and this was confirmed yesterday by the annual report of the
Medicare Trustees that says Medicare’s Hospital Insurance (HI) Trust
Fund will become insolvent slightly earlier in 2019 than reported last year.
Read more...
Fraud Grows as Private Managed Care Takes Over More
Medicaid, Medicare Patients
Wall Street Journal looks at new types of fraud; CVS
pays millions for over-billing Medicaid
March 19, 2008 – The Wall Street Journal today
asserts that as the government shoves more Medicaid and Medicare
beneficiaries to private sector managed care plans, new types of fraud
are emerging. This report hits on the same day as the report that the
giant pharmacy chain CVS agreed to pay nearly $37 million to settle
claims that it fraudulently billed Medicaid. The WSJ also examined the
growing practice of hospitals to reuse medical devices that have
designated for one time use.
Read more...
Medicare, Medicaid Veterans Health Care in
Washington Political Spotlight
Republicans want to cut Medicare, Medicaid;
Democrats want to expand VA health care, key report says traditional
Medicare more efficient than Medicare Advantage
March 12, 2008 – Republicans have introduced their
budget proposal for fiscal 2009, which calls for cuts to the critical
senior citizen programs of Medicare and Medicaid, but that was just the
hottest political move in Washington impacting health care for seniors
and veterans. A committee hearing heard a key report saying traditional
Medicare is a more efficient way of delivering benefits than Medicare
Advantage plans, which supports Democratic efforts to end government
subsidies to the MA plans. The comptroller general criticized the
government in an interview for not acting to secure the financial future
of the entitlement programs. KaiserNetwork.org also reports Democrats
trying to expand the veterans’ health care system.
Read
more...
Kohl Wants Action from Medicare Advantage Plans on
Marketing Reform
'We’ve heard pledges and promises from this group
before,' he says to recent statement by insurance trade group
March 10, 2008 - Sen. Herb Kohl (D-WI) reacted
firmly to
the recent proposal from America’s Health Insurance Plans on reforming
the marketing of Medicare Advantage plans. “We can no longer wait for
these companies to clean up their act while seniors continue to be duped
and misled,” said the chairman of the Senate Special Committee on Aging.
Read more...
Medicare Advantage Plans Higher Than Traditional
Medicare for Some Seniors
Medicare Advantage plans to cost Medicare extra $54
billion from 2009 to 2012, GAO reports
Feb. 29, 2008 - Private Medicare Advantage plans
can cost beneficiaries more than traditional Medicare for home health
care, nursing homes and certain hospital stays, according to a report
released on Thursday by the
Government Accountability Office, the
New York Times reports.
Read
more...
Health Care
Spending to Double to $4.3 Trillion by 2017; Boomers Drive Medicare
Increased use to double prescription drug spending as
prices go down, generics grow
Feb.
26, 2008 – The cost of health care in the U.S. is expected to continue to
outpace inflation and gobble up more of the nation’s gross domestic product
(GDP), according to an analysts by the Centers for Medicare and Medicaid
Services. The report published in Health Affairs says health care spending
will double by 2017, from last year, reaching $4.3 trillion. By 2017 it will
also be consuming 19.5 percent of the GDP.
Read more...
Senior Citizens Living with Heart Failure Increase
as New Cases Decline
Survival gains result in more Medicare patients
living with heart failure
Feb. 25, 2008 – The number of senior citizens being
diagnosed with heart failure has declined over the last ten years. And,
the number of elderly that are living with this condition has increased,
which is, of course, bad news for Medicare which bears the cost of care.
Read more...
Black Women Did Not Benefit as Much as White Women
from Medicare-Paid Mammograms
Breast cancer death rates for the two ethnic groups
used to be nearly identical
By Randy Dotinga, Contributing Writer
Health Behavior News Service
Feb. 19, 2008 - When Medicare began paying for
older women to undergo preventive mammograms in 1991, doctors expected
breast cancer mortality rates to drop. And, as expected, breast cancer
deaths did decrease, but new research has unveiled a discrepancy:
African-American women as a group do not benefit as much as white women.
Read more...
LA Times Says Employers Moving Retirees to Medicare
Advantage; Driving Up Cost for Other Seniors
Senate Kent Conrad (D-N.D.) called the program "a
runaway train
Feb. 12, 2008 – The financial viability of
Medicare, already badly strained, is rapidly getting worse as many local
governments, major corporations and others have learned they can shift
the cost of their retiree health care to the federal government. By
moving the retirees to Medicare Advantage they reduce their cost but
also increase the cost to senior citizens in traditional Medicare.
Read more...
Finance Committee Moves from Stimulus Plan to
Medicare Advantage Problems
Sen. Baucus says, ‘There are too many problems and
abuses.’
Feb. 8, 2008 – Fresh from a victory to get
low-income senior citizens included in the economic stimulus payments,
the Senate Finance Committee is looking at the marketing programs of the
Medicare Advantage Plans, which were supposed to have been corrected
last year.
Read more...
Cost of Entitlement Programs Driven by Skyrocketing
Health Care Costs, Aging Population
Since 1960 health care costs have grown 2.7
percentage points faster per year than the economy as a whole
Feb. 4, 2008 – There are two things that drive the
spiraling costs of the entitlement programs – Social Security, Medicare
and Medicaid – the aging population and the cost of health care. The
administration, in the new 2009 budget introduced today, presents a
brief but informational look at the two problems.
Read more...
Health Care Providers to Bear Brunt of Medicare Cost
Over-Runs in Future
Administration adds budget feature automatically reducing
payments when costs exceed 45% of funding
Feb.
4, 2008 – The 2009 budget submitted today by President Bush will reduce
Medicare spending by $556 billion over 10 years and more than $10
trillion over 75 years. Most of this will probably be paid for by
reduced payments to health care providers due a unique provision the
administration has included to require automatic annual reductions in
fees when funding no longer covers 55 percent of the costs.
Read
more...
Senior Citizen Politics
Senior
Citizen Entitlement Programs Take $208 Billion Hit in Bush Budget
President lays out $3.1 trillion budget and again
says Congress must solve financial future of Medicare, Medicaid, Social
Security
Feb.
4, 2008 - Entitlement programs – short for Medicare, Medicaid and Social
Security – will see spending cuts of $208 billion over the next five years,
if the budget proposed today by President George W. Bush is approved. The
cuts in these programs that primarily affect senior citizens are even larger
than earlier estimates. The President, today, repeatedly laid the problem at
the feet of Congress, as he did in the State of the Union address.
Read more...
Bush Budget Coming Monday Cuts Medicare, Medicaid
but Not Advantage Plan Subsidy
Medicare Payment Advisory Commission says extra fees
paid the Medicare Advantage fee-for-service plans should be cut
Jan. 31, 2008 – President Bush will release his
budget for ht 2009 fiscal year on Monday and it is expected to include
spending cuts in Medicare and Medicaid. He is not likely, however, to
take the suggestion of the Medicare Payment Advisory Commission that
extra fees paid the Medicare Advantage fee-for-service plans be
cut. The Senate Finance Committee seemed to like that idea, too,
at a hearing yesterday.
Read more...
Medicare Making Decisions Based on Profiles that Do
Not Match Beneficiaries
Cardiovascular clinical trial participants differ
in age, sex and country of residence
Jan. 30, 2008 – Despite the skyrocketing costs of
Medicare and the demand for informed decisions, Medicare is using
clinical trials with participants that do not match the characteristics
of beneficiaries to make decisions about cardiovascular products and
services. The trial participants differ in age, sex and country of
residence, according to a report in the January 28 issue of Archives of
Internal Medicine, one of the JAMA/Archives journals.
Read more...
Medicare in 2008 Has Become Costly and Complicated
for Many Senior Citizens
A brief look at the Medicare program and the costs in
2008
Jan. 21, 2008 - In the beginning Medicare was
pretty simple with few decisions required – no real challenge even for
an aging brain to understand, and a cost too low to worry about. That’s
not the case today. The Medicare program is fraught with complicated
decisions that can be costly, if a senior citizen makes the wrong
choice. Below is a brief explanation of the program and the costs for
2008 prepared by SeniorJournal.com and the Medicare Rights Center.
Read more...
Senior Citizens Need to Know Medicare's Nursing Home Care
is Very Limited
ElderLawAnswers.com says Medicare covers "acute" care as opposed to
custodial care
Jan. 18, 2008 - Many people believe that Medicare
covers nursing home stays. In fact Medicare's coverage of nursing home
care is quite limited. Medicare covers up to 100 days of "skilled
nursing care" per illness, but there are a number of requirements that
must be met before the nursing home stay will be covered. The result of
these requirements is that Medicare recipients are often discharged from
a nursing home before they are ready.
Read more...
Ohio, Pennsylvania Join Federal Effort to Increase
Planning for Long-Term Care
‘There’s a widespread misconception that Medicare
pays for long-term care’
Jan. 16, 2008 - Ohio and Pennsylvania will join a
federal program created to increase the public’s awareness about the
importance of long-term care (LTC) planning. The “Own Your Future”
education effort includes information on various ways senior citizens
can finance long-term care, according to Health and Human Services (HHS).
Read more....
Healthcare Spending Hits $2.1Trillion, Growth
Rate Grows in 2006, Says CMS
Growth slight but more than economic growth,
general inflation
| |
See below:
> Healthcare spending by age
> Report by KaiserNetwork.org on CMS news and
reactions |
|
Jan. 8, 2008 - In 2006, U.S. health care
spending reached a total of $2.1 trillion, or $7,026 per person, up
from $6,649 per person in 2005, according to a report by the Centers
for Medicare & Medicaid Services (CMS). The health care spending
growth accelerated slightly in 2006, increasing 6.7 percent compared
to 6.5 percent in 2005, which was the slowest rate of growth since
1999.
Read more...
What to Do When You Realize Your Medicare Drug or
Health Plan Does Not Meet Your Need
Information on drug and health plans provided by Medicare
Rights Center – see links below article
Jan.
4, 2008 – Sometimes, after you picked the Medicare private health or
drug plan that you thought best suited your needs, you discover in the
New Year that the plan you chose doesn’t work for you at all. Perhaps
you’ll find that your doctor or specialist isn’t part of the plan’s
network. Maybe you’ll discover that there are large copays for a
hospital stay or diagnostic procedures. Or maybe when you go to the
pharmacy, you’ll find out that your drug plan doesn’t cover your
medications. Read
more...
Senior Citizens in Medicare Prove Health Improves
with Universal Health Insurance
Those without prior insurance show greatest health
gains after reaching Medicare coverage
Dec. 26, 2007 – As the presidential candidates rush
out their ideas on universal health care, a new study of senior citizens
proves just how valuable it can be to extend health coverage to those
that do not have it. The report published today in the Journal of the
American Medical Association (JAMA) looks at the impact of Medicare,
which provides comprehensive evidence that having health insurance leads
to better health.
Read more...
Medicare Seeks Ways to Get Senior Citizens to Take
Better Care of Their Health
Awards contracts for Senior Risk Reduction
Demonstration as part of Focus on Prevention
Dec. 19, 2007 – Medicare took a big step forward in
its Senior Risk Reduction Demonstration, by awarding contracts to help
find ways to use disease prevention and health programs now used by the
private sector to encourage senior citizens covered by Medicare to do a
better job of managing their health.
Read more...
Medicare, Medicaid Pay Most of 2005 Hospital Bill
that Jumped 90 Percent from 1997
Total bill is $873 billion in 2005 with Medicare
alone paying $411 billion
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Distribution of the national hospital bill by primary payer, 2005 |
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Dec. 12, 2007 – While the presidential candidates
debate new ideas for universal health care, it is sneaking up behind us.
New numbers show U.S. hospitals charged $873 billion in 2005 – almost a
90 percent increase from the $462 billion charged in 1997. The report
also shows that the majority - about two thirds - of this bill was paid
by Medicare and Medicaid, although other government programs also helped pay
the bill.
Read more...
Three of Four Senior Citizens Refuse Medicare’s Free
Colorectal Cancer Screening
American Cancer Society estimates over 147,000 new
cases and 57,000 deaths this year
| |
Read more about
colorectal cancer and testing below article. |
|
Dec. 10, 2007 - A stunning three out of four senior citizens are
failing to take advantage of the Medicare funded screening for
colorectal cancer. It is stunning because regular colorectal cancer
screening can, in many cases, prevent colorectal cancer altogether,
according to the study published in the January 15 issue of CANCER, a
peer-reviewed journal of the American Cancer Society.
Read more...
Medicare Spends Billions Annually on Products
Available at Lower Prices
New York Times finds better prices from retail, online stores
Nov 30, 2007 - "Despite enormous buying power,
Medicare pays far more" than individuals for equipment and services that
are "available at far lower prices from retail pharmacies and online
stores," the
New York Times reports.
Read more...
Senior Citizen Politics
Drug Company Wants
to Force $2,000 Cancer Drug to Replace $40 Avastin
Sen. Kohl demands info on Genentech move that could cost
Medicare $3 billion annually for treating of macular degeneration
Nov. 29, 2007 – Sen. Herb Kohl (D-WI) stepped to the
front of the line late yesterday to intervene in a proposed limit by
Genentech in the availability of its cancer drug Avastin to certain
pharmaceutical compounding firms and pharmacies. Some physicians have
charged that Genentech’s intention in limiting Avastin’s availability is to
boost sales of Lucentis, a chemically-similar, yet far more expensive drug
also produced by Genentech and approved to treat macular degeneration.
Read more...
Medicare News
Ouch! CMS Publishes Online List of Poorest
Performing Nursing Homes
Wants to help people choose nursing homes for long-term care
Nov. 29, 2007 – Ouch! The Centers for Medicare &
Medicaid Services (CMS) today released the first ranking of the nation’s
poor-performing nursing homes, which it identifies as “Special Focus
Facilities.” CMS says the purpose is to help people choose nursing homes
for long-term care. Read
more...
Medicare Wants to Cut Hospital Pay to Create Quality
of Care Incentive
Proposal would cut all hospitals up to 5% to fund the
incentive pool
Nov. 27, 2007 - The Centers for Medicare & Medicaid
Services (CMS)
on Monday proposed changes to the Medicare hospital reimbursement system
that would reduce payments by a flat rate to create an incentive payment
pool for rewarding hospitals that meet quality-of-care thresholds, the
Wall Street Journal reports.
Read more...
Medicare Demanding Millions from Hospices Because
Patients Lived Too Long
Use of hospice by patients with less predictable life
expectancies, such as Alzheimer's disease and dementia, has
'skyrocketed'
Nov. 27, 2007 - The increase in hospice patients
who live longer than expected has led
CMS (Centers for Medicare & Medicaid Services) to demand
hundreds of millions of dollars in repayments from facilities that
exceed Medicare reimbursement limits, the
New York Times
reports. Read
more...
Osteoporosis Foundation Pushes Bill to Stop Medicare
Cuts for Testing
Group says reimbursement for DXA test will save
Medicare $1.14 billion over five years
Nov. 26, 2007 – The National Osteoporosis
Foundation has issued a news release in support of a House bill (H.R.
4206), which the group says calls for the reversal of drastic cuts in
Medicare reimbursement for Dual Energy X-ray Absorptiometry, DXA, the
imaging procedure "accepted as the gold standard" for diagnosing
osteoporosis.
Read
more...
Medicare Finalizes Expected 10 Percent 2008 Pay Cut
for Physicians
Congress expected to intervene with slight pay
increase
Nov. 2, 2007 – Physicians will receive a 10 percent
pay cut for treating Medicare patients in 2008, according to an
announcement that had been expected from the Centers for Medicare &
Medicaid Services (CMS) on Thursday. CMA said it issued a final
physician payment rule designed to improve accuracy of Medicare payments
and give physicians and health care professionals additional financial
incentives to provide higher quality and value in the delivery of care.
Read more...
Best Health Plan Ranking Includes Those Covering
Medicare, Medicaid
U.S. News & World Report, NCQA release annual
rankings for 500 health plans
Oct. 27, 2007 – A ranking for U.S. health
maintenance organizations and point-of-service plans was released today,
which includes plans that serve Medicare and Medicaid. The U.S. News &
World Report listing, however, may not be of much help to those who
don’t live in the northeast – since that is where all but one of the top
ten plans serving those in the government programs are located.
Read more...
Medicare Project Proves Pressure Ulcers Can be
Stopped in Nursing Homes
Project stopped over two-thirds of the
residents’ serious bed sores
Oct. 24, 2007 – Bed sores, pressure ulcers, decubitus ulcers – they are all the same thing – a killer that often
strikes unsuspecting victims in nursing homes. These flesh killers have
been the target the Centers for Medicare & Medicaid Services, which has
just announced a “remarkably effective” effort in preventing them in
nursing homes.
Read more...
Senior Citizen Patients in Medicare, Medicaid Not
Receiving Quality Care
Elderly patients not given full range of treatments
and services for their conditions
Oct. 17, 2007 - If the care received by vulnerable
older people concurrently enrolled in Medicare and Medicaid was
evaluated on a grading scale, it would squeak by with a barely passing
mark, a new UCLA study has found. They found that “vulnerable
elderly” patients received only 65 percent of the tests and other
diagnostic evaluations and treatments recommended for a variety of
illnesses and conditions, including diabetes and heart disease.
Read more...
Medicare Says Most Acute Care Hospitals Meet
Standards for Full Rate Increase
Senior citizens encouraged to use information as
snapshot of the quality of care being delivered
Oct. 11, 2007 – Medicare reported today that the
“vast majority of the nation’s hospitals” are reporting “valuable data”
about the quality of the care they provide to Medicare beneficiaries and
will receive a full payment rate increase of 3.3 percent next year.
Read more...
Medicare to Test Pay for Performance in Home Health
Care Demonstration
CMS will begin soliciting home health agencies for
the project this fall
Oct. 11, 2007 - The Centers for Medicare & Medicaid
Services (CMS) today announced plans for a home health
pay-for-performance demonstration, an important new step in its drive to
become a more effective purchaser of quality healthcare.
Read more...
Senior Citizen Politics
Senior Citizens Get About Half of Federal Budget in
2005: Social Security, Medicare, Medicaid
Per capita spending highest in Alaska, Virginia,
Maryland, New Mexico, North Dakota
Oct. 9, 2007 - Social Security, Medicare and
Medicaid, programs primarily serving senior citizens, accounted for more
than $1 trillion of the $2.3 trillion the federal government spent in
2005, according to the U.S. Census Bureau, which publishes the only
consolidated source of data on the geographic distribution of federal
expenditures.
Read more...
Medicare News
Senior Citizens Should Review Medicare Health Plan
Options for Changes in 2008
Most private health plans in Medicare change costs,
benefits year-to-year
Oct. 2, 2007 – Everyone enrolled in a Medicare
private health plan should review their health coverage options for next
year, since most private plans will change their costs and benefits,
according to the Medicare Rights Center (MRC).
Read more...
Medicare Part B Monthly Premium Goes Up 3.1% to
$96.40, in 2008
CMS hails it as the smallest premium increase in six
years but partially due to accounting change
Oct. 2, 2007 – The monthly charge for Medicare’s
Part B in 2008 will be $96.40. This 3.1 percent increase over this year
is heralded as the smallest rate increase in six years, but how it got
there is partially due to an accounting error that was corrected by the
Centers for Medicare & Medicaid Services (CMS).
Read more...
Medicare Drug Program News
Nine of Ten Senior Citizens Can Choose Lower Cost
Medicare Drug Plan in 2008
Enrollment change period opens Nov. 15, ends Dec. 31
with chance to lower drug plan cost
Oct.
1, 2007 – When the open enrollment period opens for Medicare on Nov. 15,
over 90 percent of senior citizens with stand-alone Part D prescription
drug plans (PDP) will be able to choose at least one plan for 2008 with
monthly premiums lower than they are paying now.
Read more...
Senior Citizen Health & Medicine
Few Senior Citizens Take Advantage of
Medicare-Provided Cardiac Rehab
Older, female, non-white: biggest offenders; varies,
too, by state
Sept. 26, 2007 – Even though Medicare pays for it,
senior citizens are terrible about following through with cardiac
rehabilitation after a heart attack or coronary bypass surgery. Fewer
than 20 percent – less than one out of five – take advantage of this
free benefit despite strong evidence that it reduces disability and
prolongs life.
Read more...
Medicare News
Seven Medicare Advantage Plans Given Green Light to
Resume Marketing
CMS says they passed ‘comprehensive marketing
review’
Sept.
25, 2007 – Seven of the Medicare Advantage Private-Fee-For-Service plans
that suspended their marketing to senior citizens after complaints of
excessively aggressive marketing are back in business. The Centers for
Medicare & Medicaid Services (CMS) announced yesterday that after being
found compliant with Medicare requirements through a “comprehensive
marketing review,” they may resume marketing.
Read more...
Several Actions Involving Medicare Highlighted by
Kaiser Health Report
CMS
has new requirements on marketing for private fee-for-service Medicare
Advantage plans
Sept. 20, 2007 – There have been several recent
developments related to Medicare. Kaiser Daily Health Policy Report
highlights some of these actions, primarily involving Medicare and the
health care suppliers they deal with in keeping the senior citizen
health insurance program running.
Read more...
Changes to Medicare Pulled from SCHIP Bill by
Negotiators
Democrats vow to make another run at changes to
Medicare
Sept. 19, 2007 – Democrats, particularly in the
House, made a bold attempt to make significant changes in Medicare as
part of the bill to reauthorize and expand SCHIP, the federal program
providing health insurance to lower income children. Those changes to
Medicare were tossed by the Senate and House negotiators, but some
Democrats say they will bring them up again.
Read more...
Senior Citizen Health & Medicine
Websites Comparing Hospital Performance Show Widely Differing Results
Hospital ranked best on one site was ranked worst on another
Sept. 18, 2007 – More than 113 million Americans, many of them senior
citizens, went to the Internet last year to seek health information.
Those checking the sites that compare hospital performance, however, may
not have found accurate information. A look at six of these sites found
Medicare and the non-profit Websites are the best for accessibility and
data transparency.
Read more...
Medicare News
Time to Prepare for Medicare’s Open Enrollment
Season – Original or Advantage?
Medicare Rights Center outlines things senior
citizens should consider
Sept. 17, 2007 - It’s fall again, the season when
health insurance companies begin marketing Medicare private health
plans. Each year, from November 15 to March 31, everyone with Medicare
has the option to change their Medicare coverage, either to Original
Medicare or to one of the private health plans known as Medicare
Advantage plans.
Read more...
Congress Must Standardize Medicare Private Health
Plans like Medigap Plans
Report by consumer groups says it will help
informed consumer choices
Sept. 17, 2007 - Congress must require that the
dizzying array of benefit packages available through Medicare private
health plans be standardized, to help Americans with Medicare make
informed decisions about choosing a health plan and to protect them from
unexpected, high out-of-pocket costs, according to the California Health
Advocates and Medicare Rights Center in a new report.
Read more...
Inequities for Poor, Minorities in Medicare’s
Private Health Plans, Report Says
Medicare Rights Center says payments to private
health plans don’t make sense
Sept. 10, 2007 - Low-income people enrolled in
Medicare private fee-for-service plans pay more for their health care in
some counties than people enrolled in the same plans in neighboring,
more affluent counties, according to a new Medicare Rights Center
report. Read more...
Results Published on Efforts to Reduce Drug Errors
Among Medicare Patients
State-by-state report on QIOs published in Managed
Care
Sept. 7, 2007 – Reducing the number of deaths among
Medicare patients from adverse drug events is a goal of the Quality
Improvement Organizations and a report on their progress has just been
published. The state by state details of how America’s QIOs are working
in partnership with Medicare Part D prescription drug plans (PDPs) and
Medicare Advantage plans (MA-PDs) to improve the quality of prescription
drug therapy for Medicare beneficiaries are reported in a supplement to
the July/August Journal of Managed Care Pharmacy.
Read more...
New Medicare Rule to Stop Physicians from Referring
Patients to Businesses Where They Profit
Final step of physician self-referral prohibition
known as the Stark law
Aug. 28, 2007 – The Centers for Medicare and
Medicaid Services today issued final regulations prohibiting physicians
from referring Medicare patients for certain items, services and tests
provided by businesses in which they or their immediate family members
have a financial interest.
Read more...
National Effort to Improve Health of Hispanic
Elderly Begins in Eight Cities
More Medicare participation and diabetes care are
major targets
Aug. 24, 2007 – Eight communities – mostly large
metropolitan markets – have been selected to participate in a Health and
Human Services pilot initiative aimed at improving the health and
quality of life for Hispanic senior citizens.
Read more...
Medicare’s Refusal to Pay Hospitals for Their Own
Mistakes Draws Editorials
When an auto mechanic breaks one part while fixing
another, would you pay for it?
Aug. 24, 2007 - Not only do hospitals use their
financial muscle to get state and federal lawmakers to protect them from
law suits brought by the errors they commit, they also want Medicare and
insurance companies to pay their bills, even if the cost was due to
their mistake. Medicare has said no more and the insurance industry may
do the same. The action drew mostly praise from U.S. newspapers.
Read more...
Medicare Will Not Pay for Preventable Conditions
Acquired at Hospitals
Most notable are infections; insurance companies
may follow suit
Aug. 20, 2007 - Medicare no longer will reimburse
hospitals for the treatment of preventable errors, injuries and
infections that occur in the facilities under a new rule scheduled for
publication this week, a move that
CMS
officials said could save lives and millions of dollars, the
New York Times
reports. Read
more...
Senior Citizens Deceived by Medicare Private Health
Plans Can Leave Plans
Medicare Rights Center says CMS fails to
explain disenrollment
Aug. 6, 2007 - People in private Medicare health
plans can disenroll from their plans if they signed up after receiving
misleading information, according to the Centers for Medicare and
Medicaid Services (CMS). To date, however, neither CMS nor the insurance
companies that operate Medicare private health plans have informed
people enrolled in these plans that they can leave if they were duped
into signing up.
Read more...
Senior Citizens Turning to Internet for Medicare,
Medicaid Information
'Telehealth' gap could be narrowing for older,
poorer Americans
Aug. 3, 2007 - Despite fears that the elderly and
poor might be missing out on health information on the Internet, a new
study shows that those most in need are bridging the telehealth gap. In
fact, older and poor Americans are likely to use the Internet to seek
out Medicare and Medicaid information, according to researchers Mary
Schmeida. Ph.D., and Ramona McNeal, Ph.D.
Read more...
Senior Citizen Alerts
Medicare Advantage Plans by America’s Health Choice
Terminated in Florida
Centers for Medicare & Medicaid Services cite
delays and denials
July 25, 2007 -
CMS on
Friday terminated Medicare Advantage plans run by
America's Health
Choice of Vero Beach, Fla., citing delays and denials of
medical care, the
South Florida
Sun-Sentinel reports. The termination, which affects about
12,000 beneficiaries, is the first CMS has made for quality-of-care
reasons. Read
more...
Fraud of Senior Citizens by Home Health Agencies is
Target for Government Initiative
Initial efforts to focus on Greater Los Angeles and
Houston areas
July 17, 2007 – An alarm about fraud of senior
citizens by home health care providers was raised today by an
announcement that Health and Human Services will begin an initiative
designed to protect Medicare beneficiaries from fraudulent Home Health
Agency (HHA) providers.
Read more...
Medicare Declares Major Success in Project Treating
Costly Chronic Disease
University of Michigan saved CMS $3.5 million and
improved care
July 12, 2007 – One out of four senior citizens in
Medicare suffers with five or more chronic conditions and they account
for 68 percent of Medicare spending. Medicare declared yesterday that
all participating physician groups participating in a demonstration
project aimed at better managing the health care of those with these
chronic conditions have improved the clinical management of diabetes
patients in the first year of the three-year Medicare Physician Group
Practice (PGP) Demonstration. Diabetes is a major chronic disease among
seniors. Read
more...
Lowering Age for Medicare May Help Offset Later Cost
of Caring for Uninsured
Older adults with chronic disease but no previous
insurance are costly to Medicare, study finds
July 11, 2007 – A new study suggests that lowering
the age to become covered by Medicare would be at least partially offset
by avoiding the additional cost for the government of caring for those
with serious chronic disease that had no insurance before reaching age
65 and joining Medicare. It may also suggest the value of some other
national health care program that would assure adequate care for people
in the earliest stages of their illness.
Read more...
Disenrolling From
Medicare Advantage Plans Difficult for Many Senior Citizens
Medicare Rights Center: no effective, seamless process to do so
July 11, 2007 - The
AP/Lexington
Herald-Leader on Monday examined problems experienced by
Medicare beneficiaries who try to switch their private Medicare
Advantage health insurance plans. "[H]undreds" of elderly residents have
contacted the
Medicare Rights
Center because they cannot disenroll from a private MA plan
purchased "as a result of misleading sales tactics," according to the
AP/Herald-Leader.
Read more...
Fraudulent Medicare Practices by Medical Equipment
Suppliers Targeted by HHS
South Florida and Southern California are focus of
effort
July 10, 2007 - A two-year effort designed to
further protect Medicare beneficiaries from fraudulent suppliers of
durable medical equipment, prosthetics and orthotics supplies (DMEPOS)
was announced today by Mike Leavitt, Secretary of Health and Human
Services. The initiative is focused on preventing deceptive companies
from operating in South Florida and Southern California.
Read more...
Medicare, Medicaid to Consume 20% of Gross National
Product by 2050
Medicare Advantage subsidy making problem worse:
Director Congressional Budget Office
June 22, 2007 -
Congressional Budget Office
Director Peter Orszag on Thursday at a hearing of the
Senate Budget Committee
said that federal spending on Medicare and Medicaid would increase from
about 4.5% to about 20% of U.S. gross domestic product by 2050,
CongressDaily
reports. Read
more...
Senior Citizens Can Now Learn More about Local
Hospital Services
Medicare improves Hospital Compare tools; adds
new information on cost of elective hospital procedures
June 21, 2007 – The Centers for Medicare & Medicaid
Services today unveiled a new version of the Hospital Compare
Website that the agency says gives senior citizens and other consumers
better insight into the quality of care provided by their local
hospitals. CMS also announced the first annual update of pricing and
volume information for certain elective hospital procedures is online.
Read more...
AARP Finds Minorities Not Taking Full Advantage of
Medicare Services
Many senior minorities passing up free flu, pneumonia
shots
June 21, 2007 – African-Americans nor Hispanics
take advantage of Medicare’s free flu and pneumonia immunization at any
where near the rate of their white senior citizen counterparts,
although, these shots can be life-saving. The statistics were revealed
today by AARP at is Diversity and Aging n the 21st Century Conference in
Los Angeles. Read
more...
Medicare to Help Senior Citizens Better Manage Their
Health Care Online
Pilot program to test the use of personal health
records online
June 21, 2007 – A pilot program aimed at
encouraging senior citizens to take advantage of Internet-based tools to
track their health care services and to provide them with other resources
to better communicate with health care providers, was announced
yesterday by Medicare.
Read more...
Bariatric Surgery Appears as Safe for Selected
Medicare Patients as Other Adults, Despite Deaths
Study says ‘surgery should not be denied solely based
on age or Medicare status’
June 18, 2007 – When Medicare began covering
bariatric surgery for severe obesity, there was an alarming number of
deaths reported. A new study, says, however, that complications after
the surgery appear to be similar between Medicare recipients and
non-recipients. They also conclude problems are the same for those under
age 60 as for those passed 60.
Read more...
Congress Advised to Cut Subsidy to Medicare
Advantage Fee-For-Service Plans
Voluntary suspension of marketing the plans warmly
received in Washington
June 18, 2007 – On Friday, seven health insurance
companies under fire for the tactics they were using to convince senior
citizens to buy their Medicare Advantage fee-for-service plans agreed to
stop their marketing until corrections can be made. KaiserNetwork.org
today looks at the reactions and also reports that the
Medicare Payment
Advisory Commission on Friday sent a report to Congress
recommending equalization of reimbursement rates for private Medicare
Advantage plans that are heavily subsidized by the government.
Read more...
Medicare Advantage Fee-For-Service Plans Pledge to
Correct Marketing Ahead of Schedule
President of America's Health Insurance Plans
issues statement
June 16, 2006 – The seven insurance companies that
voluntarily suspended the marketing of their Medicare Advantage
fee-for-service plans in an agreement with the Centers for Medicare and
Medicaid Services have pledged to correct their questionable marketing
tactics "ahead of schedule," according to a statement from the president
of the leading association of insurance companies.
Read more...
Seven Companies Suspend Marketing Medicare
Advantage Fee-For-Service Plans
CMS lays down ‘strict guidelines’ to stop deceptive
marketing
June 16, 2007 - Seven companies have agreed to
voluntarily suspend the marketing of their Medicare plans known as
Private-Fee-For-Service plans, according to the Centers for Medicare and
Medicaid Services. The action late Friday comes months after senior citizens,
advocacy groups and members of Congress began complaining about the
marketing tactics of these private insurance companies. CMS responded
with an investigation that included a “secret shopper” program to learn
the marketing tactics of the companies.
Read more...
Hispanic Senior Citizens Urged to Use Medicare More
by New HHS Program
Hispanic elderly falling behind non-Hispanic whites
in health, study finds
June 15, 2007 – Studies find a growing disparity
between the health of Hispanic senior citizens and the non-Hispanic
white elderly population. Several agencies within Health and Human
Services have joined together to launch a program to encourage Hispanic
elders and their families to take advantage of more Medicare benefits,
including prescription drug coverage, flu shots, diabetes screening and
self-management, cardiovascular screening, cancer screening services and
smoking cessation programs.
Read more...
Senior Citizens' Medicare Bill Could Quadruple by
2020 as Boomers Join, Says Medicare Trustee
Restrictions on health care spending can reduce
Medicare debt up to 40, says study for private enterprise
think tank
June
13, 2007 - Medicare's costs are rising so rapidly that substantial tax
increases, benefit cuts, or a combination of the two will be necessary,
says a Medicare trustee in a study published by a non-profit group that
advocates entrepreneurial private sector alternatives to government
regulation and control. If senior citizens bear the burden, monthly
premiums in constant dollars would have to more than quadruple by 2020.
Read more...
Oncologists Criticize Proposal to Reduce Medicare
Pay for Anemia Medications
CMS is accepting public comments on the proposal
until June 13
June 8, 2007 - A number of physicians attending the
American Society of
Clinical Oncology annual meeting in Chicago this week
expressed concern that
CMS "has
gone too far" with its proposal to limit Medicare reimbursements for the
treatment of cancer patients with anemia medications manufactured by
Amgen
and
Johnson & Johnson,
Dow Jones reports.
Read more...
Little Care Improvement by Hospitals in Medicare
Pay-for-Performance Program
Bonuses of $17.6 million were awarded to 238
hospitals in two years
June 6, 2007 - Hospitals participating in a
Medicare pay-for-performance pilot program were not significantly more
likely than non-participating hospitals to provide better treatment,
according to a three-year study published in the Journal of the American
Medical Association, the Wall Street Journal reports.
Read more...
AMA Survey Says Physicians Won't Take Medicare
Patients if Pay Gets Cut
Campaign to stop physician payment cuts says senior
citizens lose
June 4, 2007 - Medicare patients’ ability to get in
and see the doctor will be severely hampered next year by a steep
Medicare cut to physicians, according to a
new survey released today by the American Medical Association (AMA).
Read more...
Hospital Groups Outraged with Medicare Rule They Say
Will Reduce Pay Increase
‘Back-door budget slashing’ and would cost
hospitals $2.4 billion
June 4, 2007 - Hospital associations are "in a
state of outrage" over a Medicare rule proposed by
CMS that
they say would reduce a scheduled increase in hospital reimbursements by
assuming hospitals will "game the new system," the
Philadelphia
Inquirer reports.
Read more...
Debate over Reducing Medicare Advantage Plan
Payments Continues
CMS Administrator says they offer better preventive
health benefits than traditional Medicare
May 30, 2007 - Lawmakers continue to debate whether
to reduce federal payments to private insurers that administer the
fastest-growing type of Medicare Advantage plans -- private
fee-for-service plans, the
AP/Atlanta
Journal-Constitution reports.
Read more...
Congress, AMA, Advocates All Targeting Medicare
Advantage Private Fee-for-Service Plans
AMA says most members report their patients were
denied coverage
May 24, 2007 – The spotlight in Congress and in
Medicare advocacy circles is increasing the focus on problems in the
Medicare Advantage Private Fee-for-Service Plans. A powerful House
member says he wants to cut the questionable high fees paid to these
plans and the American Medical Association released a survey saying most
of the physicians report that their patients in a Medicare Advantage HMO
or PPO plan were denied coverage of services typically covered in the
traditional Medicare.
Read more...
Understanding of Medicare Advantage Private
Fee-for-Service Gained from New Report
Center for Medicare Advocacy finds problems with
access, consumer protections
May 24, 2007 – A timely new report from the Center
for Medicare Advocacy describes the Medicare Advantage Fee-for-Service
Plans, the rules and regulations in which they operate and compares
these to those for other Medicare Advantage (MA) plans. It also reviews
PFFS plans in three states and compares the cost-sharing expense with
traditional Medicare and with traditional Medicare plus a Medigap
policy. Read
more...
Hospital Death Rates for Heart Attack, Failure in
Medicare Patients to be Published by CMS
Centers for Medicare & Medicaid Services provides
seniors 'Hospital Compare'
May 24, 2007 -
CMS in
June will post the first broad comparison of hospital mortality rates
for heart attack and heart failure in Medicare beneficiaries on the
Hospital Compare
Web site,
USA Today
reports. Hospital mortality rates currently "are among the best-kept
secrets in American medicine" and remain "closely guarded," according to
USA Today. Read
more...
Medicare Advantage Marketing Tactics Get Scrutiny of
Senate Aging Committee
Chairman Kohl notes some plans have announced
reforms
May 16, 2007 – Amidst growing concern about the
aggressive marketing tactics of Medicare Advantage plans, the Senate
Select Committee on Aging held a hearing today that shed new light on
the problem from the point of view of the senior citizen consumer, the
Centers for Medicare and Medicaid and the insurance companies.
Read more...
CMS Questions Marketing Tactics of Medicare
Advantage Plans
They fail to tell seniors they are not 'traditional'
Medicare
May 8, 2007 - The Wall Street Journal on Tuesday
examined how Medicare Advantage private fee-for-service plans are
"coming under increasing fire" from
CMS
officials "worried about
tactics
used to market them" and from lawmakers who believe the plans receive
"exorbitant government payments."
Read more...
Medicare Rights Center Finds Problems with Care from
Private Health Plans
Advocacy group calls for Congress to end the
'Overpayments'
April 30, 2007 – Senior citizens and disabled
Americans discover a host of problems, including unanticipated costs and
barriers to getting care, when they get sick and need care through their
Medicare private health plans, according to a new report from the
Medicare Rights Center.
Read more...
Medicare Trustees Annual Report Requires Response
from Bush on Funding Problem
Second year projecting over 45% must be
funded by general revenues
April 23, 2007 – The Medicare Trustees released
their annual report today, which as expected, projects program costs
financed by general revenues, rather than dedicated revenue, are
expected to exceed 45% in 2013. Because this was the second consecutive
year of such a projection, it triggers a funding warning that requires
President Bush to propose legislation to respond to the issue within 15
days following the release of the Fiscal Year 2009 Budget, which will be
in early February, 2008. There were pieces of good news, however,
including cost projections for the Part D drug program that are 13%
lower than last year.
Read more...
Medicare Proposes Adjusting Hospital Payments Based
on Severity of Illness
Specialty hospitals are a particular focus of the
proposal
April 16, 2007 -
CMS on
Friday announced a proposed rule that would increase the Medicare
inpatient reimbursement rate for hospitals that report data on quality
of care to the agency and base payments on the severity of
beneficiaries' illnesses,
CQ HealthBeat
reports. Read
more...
Medicare Commission Wants Independent Research on
Services
Also calls for reducing confusion on drugs covered in
Part D
April 16, 2007 - The
Medicare Payment
Advisory Commission on Thursday voted to include a
recommendation in a June report to Congress that lawmakers "charge an
independent entity to sponsor credible research on comparative
effectiveness of health
