News

  • Legislative Update January 2013

    Now we are looking for viral deliverance when drug development is one of the world's most lucrative businesses, ownership of drug patents is disputed in endless court battles, and monopoly power often lets manufacturers set any price, no matter how extraordinary. A new cancer treatment can cost a half-million dollars, and old staples like insulin have risen manifold in price to thousands of dollars annually. .Since 2000, COLAs have increased Social Security benefits a total of 55 percent, yet typical senior expenses through July 2021 grew 104.8%. The average Social Security benefit in 2000 was 6 per month. That benefit grew to ,262.40 by 2021 due to COLA increases. However, because retiree costs are rising at a far more rapid pace than the COLA, this study found that a Social Security benefit of ,671.20 per month (8.80 more) would be required just to maintain the same level of buying power that 6 had in 2000. .The House of Representatives has outlined specific reforms that maintain the current Medicare program for those aged 55 and older with no disruption and saves Medicare for future seniors by offering those beneficiaries a premium support program. Specifically for younger workers, when they reach eligibility, Medicare will provide a payment and a list of guaranteed coverage options – including a traditional fee-for-service option from which recipients can choose a plan that best suits their needs. These future Medicare beneficiaries will be able to choose a plan the same way members of Congress do. Medicare will also provide additional assistance for lower-income beneficiaries and those with greater health care needs. Our plan also stops the raid on Medicare trust fund that was going to pay for the Patient Protection and Affordable Care Act, allowing any current Medicare savings to go directly to saving Medicare and not creating open-ended health entitlements. … Continued

  • Legislative Update For Week Ending July 25 2014

    Congress did not receive any automatic pay adjustment this year. With so many Americans (including seniors) suffering from long-term financial set backs, and so many workers out of jobs, lawmakers wisely opted to forego a raise. They last received a pay raise in January 200At the time their salary was increased 2.8% to 4,000 from 9,300. While the recession was taking a bite out of Americans' income, the pay of Members of Congress grew by ,800 from the time the recession began at the end of December 2007 through 2009, according to the Congressional Research Service. Over the decade 2000 through 2009, Congress gave themselves a total of 9 pay hikes, raising their salaries a total of ,300 from 6,700 in 1999 to the 4,000 that they receive in 201Legislation passed in 1989 established the current formula used to automatically adjust the Congressional pay increase that they refer to as a "cost-of-living adjustment" (COLA). .However, if a waiver would have been included in the Covid relief bill Senate rules would have required there that 60 votes in favor of passage would be needed instead of a simple majority of 51. .Sources: "Humana Inc. Overcharged Medicare Nearly 0 Million, Federal Audit Finds," Fred Schulte, NPR, April 20, 202"Insurers Running Medicare Advantage Plans Overbill Taxpayers By Billions As Feds Struggle to Stop It," Fred Schulte and Lauren Weber, Kaiser Health News, July 16, 201"Reducing Medicare Advantage Overpayments," Committee for a Responsible Federal Budget, February, 23, 2021. … Continued

If signed into law, the PRIME Act would take a number of steps to prevent and reduce fraud, waste, and abuse within the Medicare and Medicaid programs. Among other things, it would enact stronger fraud penalties, curb mistaken payments by the agencies, phase out the ineffective "pay and chase" practice, reduce the theft of physician identities, and improve the sharing of fraud data among states, agencies, and programs. .Social Security defines an overpayment as "any time beneficiaries receive more than they should have." This occurs for a number for reasons, but most frequently when Social Security isn't notified of changes, such as a death of a beneficiary or excess earnings when working. Overpayments can also be due to errors by the Social Security Administration, but even when the overpayments are Social Security's own fault, the beneficiary must prove he or she is not at fault. .Early this week, the Office of the Inspector General (OIG) for the Social Security Administration released a 10-year study that found nearly billion in overpayments to around 4 million enrollees in the Disability Insurance program. Approximately 45 percent of all disabled beneficiaries have been overpaid in the past decade, the report's authors concluded. .The CPI-E tends to grow more quickly than the CPI-W in most years, because it more accurately accounts for the percentage of income that retirees spend on healthcare and housing costs. Those two categories tend to increase several times faster than inflation, and tend to take a bigger share of retiree income. The CPI-E tends to give less weight to items like gasoline and consumer electronics which have fallen significantly in recent months and helped drag down the COLA for 2020. .TSCL is concerned that illegal immigrants who gain temporary work permits and Social Security numbers would become permanently eligible for Social Security and Medicare among other federal benefits. Here are several areas of concern: .In addition, the Secretary of Health and Human Services (HHS) is prohibited from negotiating directly with pharmaceutical companies on behalf of the more than 40 million Americans who get their prescription drug coverage from Medicare Part D. . Double check the price quote that you received by checking the difference in price between several retail walk-in pharmacies and Humana's mail-in. Sometimes the price can be very different between the two. I learned that my drug plan's mail-in pharmacy would charge me 3 for three albuterol inhalers. The small local walk-in pharmacy was still charging just 1.99 for three. Often, mail order can be less expensive than walk-in retail. Check for each separate drug. You can use the Medicare drug plan finder to help you look up your plan and learn the cost of your co-pay or co-insurance. .The exact mechanisms for enacting the provisions therein — such as requiring manufacturers to reveal their development costs — remain unclear. The industry has previously protected development data as a trade secret. The bills would also require "reasonable pricing clauses" be included in agreements between drug companies and agencies funding their work. They propose waiving exclusive licenses for COVID-19 drugs, allowing competitors to sell the same products as long as they pay the patent holder royalties. .According to Mr. Brune, SSA is making several organizational and technology-driven improvements that will lead to an increase in fraud detection. The administration is currently expanding its successful Cooperative Disability Investigations (CDI) program, which prevents benefit payments from being made in cases where fraud is detected. The CDI program is operating in thirty-three states this year, and it is expected to expand to the remaining seventeen states by 202Mr. Brune said, "Chairman Johnson and this Subcommittee have long championed this CDI program, and we thank you for that support."