Medicare

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.

Medicare Penalizes 29 Florida Hospitals For Safety Incidents

Dec 15, 2015

The federal government is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those places had also been fined last year, Medicare records released late Wednesday show.

A national healthcare company showed off its first Florida clinic today and it’s right here in Jacksonville. 

Alignment Healthcare is partnering with St. Vincent’s HealthCare and Florida Blue to provide comprehensive care to Medicare patients in Clay and Duval Counties.

Alignment Healthcare’s Chief Medical Officer Doctor Henry Do says one way they do that is with what’s called population care.

In recent months, hospital systems in Florida have paid out hundreds of millions of dollars to settle allegations of illegally compensating physicians. According to Modern Healthcare, those huge settlements are catching the attention of other potential whistleblowers.

End Of Medicare Bonuses Will Cut Pay To Primary Care Doctors

Nov 30, 2015

Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients.

Associated Press

With time running out on open enrollment season, many seniors are facing sharply higher premiums for Medicare's popular prescription drug program. The reason: rising drug costs have overtaken a long stretch of stable premiums.

With time running out on open enrollment season, many seniors are facing sharply higher premiums for Medicare's popular prescription drug program. The reason: rising drug costs have overtaken a long stretch of stable premiums.

U.S. Army

Striving for better quality and more predictable costs, Medicare on Monday launched a major payment change for hip and knee replacements, the most common inpatient surgery for its 55 million beneficiaries.

.S. Department of Health and Human Services

One month into Medicare's enrollment period for seniors, the federal government announced that Medicare Part B premiums will be going up in 2016 for new enrollees.

Not every American 65 and older is worrying about Medicare's open enrollment period, now underway. Some who are eligible for the government insurance plan are staying on the job, and gaining access to employer-based plans they say are a better option. 

WellCare Sees Increase In Earnings

Nov 5, 2015
WellCare

Tampa-based WellCare Health Plans, which manages care for about 800,000 people in Florida's Medicaid program, saw an increase in earnings during the third quarter of the year, according to a filing Wednesday with the federal Securities and Exchange Commission.

Medicare said last week it will pay doctors to help patients plan what kind of care they want at the end of life, an idea more broadly accepted than six years ago, when it touched off a political uproar about “death panels.”

The Justice Department said Friday that it had reached settlements totaling more than $250 million with hundreds of hospitals where doctors implanted cardiac devices in violation of Medicare coverage requirements.

Daylina Miller/Health News Florida

Seniors enrolling in Medicare are facing a tough decision when it comes to which plans they should sign up for.

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