Democrats Eye Medicare Advantage

From the Wall Street Journal Online

http://online.wsj.com/article/SB122920867695704427.html.html

Democrats start looking at the Medicare Advantage programs and drug programs.

Posted under Medicare Advantage, Medicare Bills, Part D

This post was written by admin on December 13, 2008

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Medicare’s “non-payment” policy for errors: a closer look - Chicago Tribune

Chicago Tribune, United States
A month ago, with considerable fanfare, Medicare started withholding payments to hospitals for errors that harm patients. The move gives medical centers a READ MORE

Posted under Medicare Bills

This post was written by admin on November 6, 2008

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New Medicare Bill Update 2

Bill H.R. 6331 made some changes to modernize the plans. Some changes, eliminations, and additions to the plans have been approved, however the states still have to addopt the changes and the companies will need to decide if they are going to offer the new plans, and if so get setup to do so.  So with the information below, please keep in mind it is estimated that these changes will take effect around June of 2010.  Information below is subject to change, and is for informational purposes only.

***NOTE***

THOSE OF YOU ALREADY ON PLAN J OR ANY OTHER PLAN BEING ELIMINATED WILL BE ALLOWED TO KEEP YOUR CURRENT PLAN, YOUR POLICY WILL NOT BE AFFECTED.  After the changes take place, the regulations will not allow anyone new to be placed into those plans that are eliminated, but those in those plans will be grandfathered in.  Call us with your concerns!

Even with the elimination of some plans, we still believe that Plan J currently gives you the best bang for your buck and suggest to get in now while you can if you qualify.   

The new regulations includes transition standards to permit companies to offer existing policyholders or certificate holders the opportunity to exchange their current policy for a new policy. Once we get closer to this time frame, give us a call and we can share the details of that process with you.

As for the NAIC Medicare Supplement Modernization Proposal suggest the elimination of unnecessary and duplicative plans:

  • Elimination of Supplement plans H, I, J because these plans no longer offer the drug benefit.  The drug benefit was replaced with Medicare Part D.
  • Supplement plan E will also be eliminated, because it becomes identical to a plan already available after the plan benefits are changed.

Modernization of benefits:

  • The elimination of the At-Home Recovery benefit (which was offered only in Plans D, G, I, and J)
  • The elimination of the Preventive Care Benefit (which was offered in plans E and J)
  • Addition of a Hospice benefit as a Core benefit to every pan
  • Replacement of the 80% Part B Excess Benefit in Plan G with a 100% coverage benefit

Plans M and N to be added as follows:

  • New Plan M will include 50% coverage of the Medicare Part A deductible and does not cover the Medicare Part B deductible.
  • New Plan N will not cover the Medicare Part B deductible and will add a new co-payment structure of $10 for each physician visit and $50 for each emergency room visit (which will be waived upon admission to the hospital)

If you are concerned about the changes in the system, give us a call so we can discuss your options.

Posted under Medicare Bills

This post was written by admin on August 27, 2008

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New Medicare Bill Update

From the Pacesetter magazine from Genworth Financial Aug/Sep 2008

Congress overrode the President’s veto to pass the Medicare Improvements for Patients and Providers Act of 2008 into law on July 15, 2008.  The main focus of this bill was to eliminate the planned 10.6% decrease in payments to doctors, but the act also contained a number of changes for Medigap and Medicare Advantage (MA) plans.

Starting in June 2010, there will be a number of changes to Medigap policies as recommended by the National Association of Insurance Commissioners (NAIC):

  • Plans E, H, I, and J, will no longer be available.
  • Two new plans (M & N) will be implemented with higher cost-sharing and lower premiums.

MA plans will also undergo a number of changes:

  • Marketing of MA plans will be significantly restricted. Cold calling, marketing at educational events, and offering meals to seniors are prohibited.
  • The Centers for Medicare and Medicade Services are requiring MA plans to limit compensation paid to agents to incent agents to enroll seniors in the plans that best meet their needs.
  • Payments to MA plans were cut by $12.5 Billion over 2009-2013.
  • Private-fee-for-service MA plans are required to build provider networks by 2011 and to have Quality Improvement plans by 2010.

We believe that the changes liste above will be good for seniors and the Medigap market.  There is another planned decrease in pyaments to doctors (20%) scheduled for 2010.  That will open the door to more potential changes to Medigap and MA plans. Stay tuned…

***NOTE***

Those of you currently on a plan that is to be eliminated, will continue on your plan, and you will not see any changes.  After the regulation takes place, no new business will be allowed into those plans.  If you have any concerns, please call us!.

Posted under Medicare Bills

This post was written by admin on August 18, 2008

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Congress overrides Presidential veto of Medicare bill

This is from NAHU:

The (7/16, Gaouette) reports that “Congress delivered a stern rebuke to President Bush on Tuesday, overriding his veto of a Medicare bill, and preventing pay cuts to doctors who treat seniors, the disabled, and military personnel.” The measure “halts a scheduled 10.6 percent cut in payments to physicians, and institutes a 1.1 percent payment increase in 2009.” Even though the President had “little chance of prevailing, Bush issued the veto [Tuesday] morning, declaring the bill ‘objectionable,’” and “fiscally irresponsible.”

According to the (7/16, A13, Pear), “In his veto message, Mr. Bush said he objected to the bill because it would cut federal payments to Medicare Advantage plans and slow the growth of such plans, offered by insurance companies as an alternative to traditional Medicare.” The President added, “I support the primary objective of this legislation, to forestall reductions in physician payments,” but “taking choices away from seniors to pay physicians is wrong.” The Times points out, however, that “[m]any independent studies have found that the private plans, sold by insurers like Humana and UnitedHealth, cost the government more per person than traditional Medicare.” Still, the President insisted “that reducing payments to the plans would force them to ‘reduce benefits to millions of seniors.’”

Just hours after the veto, the “House voted 383 to 41 to override” it, “while the Senate voted 70 to 26, in both cases far more than the two-thirds necessary to block the President’s action,” the (7/16, A2, Abramowitz, Kane) adds. By casting this vote, “Republicans broke heavily from the White House. A total of 153 House Republicans voted to defy the White House, 24 more than in a June 24 vote that started the momentum toward passage of the Medicare doctors’ bill” Tuesday. Furthermore, “21 Senate Republicans voted for the bill this time, including four senators who had voted ‘nay’ in the two previous Medicare votes.”

The (7/16, A6, Mathews) reports that the “new law is a victory for Democrats after a partisan standoff that dragged on for weeks. It was broken dramatically last week when Massachusetts Sen. Edward Kennedy (D-Mass.) returned to the Senate floor to cast a decisive vote.” The Medicare measure “is also a win for doctors, among other lobbying interests, largely at the expense of health insurers,” which “will face cutbacks to the Medicare” Advantage plans they offer.

The (7/16, Freking), (7/16, Marcus), Minnesota’s (7/16), (7/16, Armstrong), (7/16, Young), ’s (7/15, Winter) On Deadline blog, the ’s (7/15, Graham)Triage blog, the (7/16, Ward), (7/15, Walker), (7/15, Lubell), and (7/15) also covered the story.

Various health sectors benefit from Medicare veto override. (7/16, Young) reports that “[a]lmost lost amid the donnybrook between physicians and health insurers over Medicare is how many other healthcare sectors scored wins in the Medicare bill that” passed Tuesday. For instance, the legislation “includes a delay in the implementation of a competitive bidding program that most of the DME [durable medical equipment] industry opposed, led by the American Association for Homecare and companies like Invacare and American HomePatient, that make or sell oxygen tanks, wheelchairs, diabetes test strips, and other supplies.” In addition, the “drugstore industry won some long-sought-after provisions in the legislation,” such as the “requirement that drug plans pay pharmacies for the medicines they dispense within 14 days.” And, the “bill…contains provisions to delay the implementation of a change to the Medicaid drug pricing formula, called ‘Average Manufacturer Price,’ opposed by pharmacies.”

Posted under Medicare Bills

This post was written by admin on July 16, 2008

Bush Vetoes Medicare Bill

President Bush vetoed legislation Tuesday that would undo a 10.6 percent cut in Medicare fees to physicians.

The expected veto sets up action in the House and Senate, with both chambers planning on holding votes later Tuesday aiming to overturn Bush’s veto. 

Complete story at The Hill.com. 

Posted under Medicare Bills

This post was written by admin on July 15, 2008

Medicare Advantage takes a blow

And so the process begins…  In the article below, it talks about the recient law that was passed that prevents the cuts in payments to doctors who provide care for Medicare patients which is good news for the majority of our seniors.  The payments were sustained by reducing the amount the government pays to the Medicare Advantage plans which are run by private insurers such as Humana, United Healthcare, Coventry, and Aetna. The cuts come from plans who provide “fee for service” and payments to private plans with teaching hospitals in their areas, which are called “indirect medical education” payments.

With studies showing that this year (2008) Medicare Part A (Hospital Care) will pay out more than it will take in,  within the next 12 years the trust fund that holds the funds to pay these bills will run dry due to the increase in both the number of seniors entering the program and increases in medical care costs.  

My fears about Advantage plans are coming true.  I only expect this problem to get worse.   If you are shopping for a new program, give us a call so we can discuss your options with all the information you need to properly make a good decision for the long run.

07/09/2008 CNN Money article about the advance of current medicare bill

Posted under Medicare Advantage, Medicare Bills, Medicare Supplement

This post was written by admin on July 10, 2008

Kennedy returns to decide Medicare vote

Kennedy returns to vote on Medicare procedural vote.  Several Republicans flipped and the procedural vote passed 69-30.  Following the procedural vote, the Senate passed the bill with a veto-proof majority.

Here is the full story at TheHill.com

Posted under Medicare Bills

This post was written by admin on July 9, 2008