Medicare

Seniors who like their Medicare choice this year, shouldn't assume it will be the same next year.

A doctor in your network this year could be out of network next year. The same goes for a prescription drug that is covered this year.

Seniors who aren't comparison shopping during Medicare open enrollment, could see their costs increase.

Colleen Krepstekies with the AARP says her agency can connect seniors to organizations that can help them navigate the enrollment process.

WellCare

WellCare Health Plans, Inc., one of the largest public companies and one of the largest employers in Tampa Bay, has signed an agreement that expands its footprint in Arizona’s Medicaid and Medicare markets, according to the Tampa Bay Business Journal.

Drew Makepeace / Flickr

A majority of Americans favor government action to restrain prescription drug prices, according to a poll released Thursday.

CMS Identifies Hospitals Paid Nearly $1.5B In 2015 Medicare Billing Settlement

Aug 23, 2016

A year after paying nearly $1.5 billion to more than a third of U.S. hospitals to resolve longstanding Medicare billing disputes, the Obama administration has disclosed who got paid.

Medicare’s Readmission Penalties Hit New High

Aug 3, 2016

The federal government’s penalties on hospitals will reach a new high as Medicare withholds more than half a billion dollars in payments over the next year, records released Tuesday show.

Some Seniors Surprised To Be Automatically Enrolled In Medicare Advantage Plans

Jul 27, 2016
Kaiser Health News

Only days after Judy Hanttula came home from the hospital after surgery last November, her doctor’s office called with bad news: Records showed that instead of traditional Medicare, she had a private Medicare Advantage plan, and her doctor and hospital were not in its network.

Kaiser Health News

Despite objections from Congress and the hospital industry, the Obama administration said it will soon publish star ratings summing up the quality of 3,662 hospitals. Nearly half will be rated as average, and hospitals that serve the poor will not score as well overall as will other hospitals, according to government figures released Thursday.

Appeals Court Rules Against St. Pete Nursing Home In Medicare Fight

Jul 12, 2016
Google Maps

A federal appeals court Monday said a bankruptcy judge did not have the authority to block health officials from cutting off Medicare and Medicaid payments to a Florida nursing home that was alleged to have violated patient-care regulations.

More Than 100 Charged In Florida In Health Care Fraud

Jun 22, 2016
U.S. Department of Justice

In what the U.S. Department of Justice described as an "unprecedented nationwide sweep," more than 100 people in Florida have been charged with crimes related to Medicare and Medicaid fraud, the federal agency announced Wednesday. 

A program that has helped seniors understand the many intricacies of Medicare, as well as save them millions of dollars, would be eliminated by a budget bill overwhelmingly approved last week by the powerful Senate Appropriations Committee.

Medicare Releases Draft Proposal For Patient Observation Notice

Jun 15, 2016

In just two months, a federal law kicks in requiring hospitals to tell their Medicare patients if they have not been formally admitted and why. But some physician, hospital and consumer representatives say a notice drafted by Medicare for hospitals to use may not do the job.

Younger people may not realize it, but seniors know well that Medicare doesn't cover all health-related needs and expenses. Many Medicare beneficiaries have some kind of supplemental insurance that partly covers the gaps. But those policies mainly provide financial protection for the patient's share of costs for regular doctor visits and hospital care covered by Medicare. Until 2006, Medicare didn't cover prescription drugs.

Some things that Medicare doesn't cover:

Demand for long-term care is expected to increase as the nation ages, but the majority of Americans 40 and older lack confidence in their ability to pay for it.

Elderly Book End-Of-Life Talks Once Labeled 'Death Panels'

May 23, 2016

The doctor got right down to business after Herbert Diamond bounded in. A single green form before her, she had some questions for the agile 88-year-old: about comas and ventilators, about feeding tubes and CPR, about intense and irreversible suffering.

Healthcare spending for some services dropped by nearly a third when people turned 65 and switched from private insurance to Medicare, according to a recent study. The decline was driven by lower prices paid by the Medicare program to doctors and other providers rather than a drop-off in the volume of services seniors receive.

A diabetes prevention program being tested by the YMCA of the USA has proved successful at reducing the risk of developing the disease, according to the Department of Health and Human Services.

So the Obama administration wants Medicare to pay for the services for beneficiaries at high risk of developing diabetes.

Long-term Care Insurance: Less Bang, More Buck

Mar 17, 2016
Heidi de Marco / Kaiser Health News

Mary Julia Klimenko thought she was prudent 20 years ago when she invested in a long-term care insurance policy, one she believed would help pay for the care she’d need as she aged.

Now she wishes she’d banked the money instead.

Doctors have long disputed the accusation that the payments they receive from pharmaceutical companies have any relationship to how they prescribe drugs.

There's been little evidence to settle the matter, until now.

A ProPublica analysis has found that doctors who receive payments from the medical industry do indeed prescribe drugs differently on average than their colleagues who don't. And the more money they receive, the more brand-name medications they tend to prescribe.

Doctors Ponder Delicate Talks As Medicare Pays For End-Of-Life Counsel

Mar 16, 2016
www.healthcare.gov

She didn’t want to spend the rest of her days seeing doctors, the 91-year-old woman confessed to Dr. Kevin Newfield as he treated a deep wound on her arm.

Medicare is going to test new ways to reimburse doctors for medications, in hopes they'll choose less expensive drugs.

The plan would alter Medicare Part B, which pays for medicines administered in doctors offices or outpatient hospital clinics — to eliminate incentives for doctors to use the most expensive drugs.

Insurance giant Humana Inc., which operates some of the nation's largest private Medicare health plans, knew for years of billing fraud at some South Florida clinics but did little to curb the practice even though it could harm patients, a doctor alleges in a newly unsealed whistleblower lawsuit.

Dueling Star Ratings May Confuse Some Home Health Patients

Feb 23, 2016

Patients looking for home health care services will be impressed if they check out the federal government’s ratings of Brookdale Senior Living. Four of the company’s home health agencies — in Florida, North Carolina, Ohio and Rhode Island — each earned five stars, the top quality score, primarily based on Medicare’s assessment of how often patients got better.

Senators Reject Major Health Regulation Change

Feb 18, 2016

With hospitals, nursing homes and hospice providers lined up in opposition, a Senate panel Wednesday rejected a proposed overhaul of a key regulatory process for new health-care facilities.

Delay Of New Health Law Forms May Confuse Some Taxpayers

Feb 16, 2016

As the 2015 tax filing season gets underway, tax preparers said a delay in new health law tax forms is causing confusion for some consumers, while others want details about exemptions from increasingly stiff penalties for not having insurance.

Health insurer UnitedHealthcare will partner with a local doctor’s group in a move they say will lower health care costs.

Florida Attorney General Pam Bondi says she was wrong to urge the U.S. Centers for Medicare & Medicaid Services to pay for high-priced and unnecessary drug screening tests from a company being investigated for defrauding Florida Medicaid of millions.

Evan Lewis / Associated Press

Whether it’s coverage for end-of-life counseling or an experimental payment scheme for common surgeries, Medicare in 2016 is undergoing some of the biggest changes in its 50 years.

Medicare officials say researchers and the public will now have an easier way to analyze spending on costly prescription drugs.

Seven hospitals in Florida have agreed to pay the federal government about $9 million to settle allegations they submitted false claims to Medicare for a minimally-invasive procedure commonly used to treat spinal fractures from osteoporosis, a news release from the U.S. Department of Justice says.

A Fort Myers-based integrated cancer care services provider accused of billing for tests that were not needed will pay nearly $20 million to the federal government to settle allegations from a whistleblower that it violated the False Claims Act, according to a news release from the U.S. Department of Justice.

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