Final Announcement: HMC is now part of Health Care – From Policy to Practice

The HMC blog is now part of Health Care – From Policy to Practice blog. We have more content, news and networking available to share with you on this new blog. Thanks for your continued readership and make sure to subscribe to the new feed.

http://healthcareinsights.blogspot.com/

Healthcare Insights To Launch in 2009!

We're getting ready to launch a new blog that looks at the broader issues of Healthcare, providing breaking news, insights and strategies into Health Plan business and operations., update your RSS feed now as we get it ready for our official launch:

http://healthcareinsights.blogspot.com/

See you at MAC!

For some time now you've probably noticed our linking to a new sister blog titled Medicare Advantage Congress. Our new blog will looks at the healthcare landscape from academic, industry, policy & provider view points on all issues related to Medicare Advantage.

Since we've established this corresponding blog we want to officially invite you to join us and subscribe to our feed: http://feeds.feedburner.com/MedicareAdvantageCongress

As you've already seen, we've been building up the Medicare Advantage Congress blog with the same quality content that you find here. Beginning today, this will be our last post on this blog but you can join us on the MAC blog, where we hope you'll continue to actively participate as you have here. Thank you and we look forward to seeing you!

Brand-Name Drugs are Favored by Medicare Beneficiaries

According to this article in EmaxHealth, brand-name medications account for almost two-thirds of all prescriptions filled by Medicare beneficiaries. Patients are asking for brand-name drugs when the program provides coverage and are asking pharmacists for generic drugs when they have to pay out of pocket.

When patients switch from brand-name to generic drugs, more than likely they’ve reached the coverage gap in which they must cover the full cost of the prescriptions. Woody Eisenberg, Medco Chief Medical Officer mentions that when Medicare beneficiaries become aware of the coverage gap they "become acutely aware of the cost difference between brand-name and generic drugs and most make the switch."

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Billions Paid in Medicare Suspect Claims

The National Center for Policy Analysis reports that billions of taxpayer dollars have gone to waste because Medicare has paid out claims with blank or invalid diagnosis codes over the past decade according to a new Senate report.

Claims for wheelchairs, drugs, and other medical supplies of Medicare patients were reviewed from 2001 to 2006. During these years, they found at least $1 billion of medical equipment which listed diagnosis codes that had little or no connection to the reimbursed medical items. Here are some findings from the report:

• Medicare paid millions of dollars to medical suppliers for blood glucose test strips -- used exclusively for diabetics -- based on non-diabetic diagnoses.
  
• Roughly $4.8 billion in payments were made from 1995 to 2006 despite invalid coding or nothing listed at all; about $23 million of that amount was paid after 2003, when federal rules made clear the codes were required.
• Based on a sample of 2,000 of those invalid coding claims, investigators found more than 30 percent could not be verified as legitimate and "bore characteristics of fraudulent activity."
• Federal regulations require that Centers for Medicare and Medicaid Services (CMS) pay only for items that are deemed "medically necessary," yet, CMS does not examine diagnosis codes to determine whether the equipment is actually necessary before making payment.
• Only 3 percent of claims are reviewed after payment is made.
  

Sources:
http://hsgac.senate.gov/public/
http://townhall.com/news/us/2008/09/24/probe_medicare_paid_billions_in_suspect_claims

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare Monthly Premium Costs Remain the Same for Elderly and Disabled in 2009

AHN reports that Medicare premiums for the disabled and elderly will remain constant at $96.40 next year, according to the U.S. Centers for Medicare & Medicaid Services.

The premium and deductible paid by consumers cover home health facilities, durable medical equipment, and cost of physicians. The Medicare Part B Program will also retain its costs at $135 this year. So far the only costs expected to rise is monthly premium payment for Part A coverage which will rise form $423 to $443 in 2009.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Medicare rates to stay the same for 2009

According to Elder Law Answer, it was announced recently that Medicare's monthly premium will stay the same for the first time in eight years. The monthly premium will remain the same, totaling $96.40 a month.

This fee covers portions of fees related to physicians services, outpatient hospital services, and other items.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.