News
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Ask The Advisor August 2020
The first new rule affects Medicare Part B drug costs, which are typically infused or injected drugs used mainly in the treatment of cancer. The intent is to cap the cost of those drugs at the lowest price that drug manufacturers receive in other countries and to pay doctors a flat fee for each dose of a drug, instead of a percentage of each drug's cost. .Congressional Republicans have also indicated opposition to the administration's proposal, saying it breaks from GOP philosophy by linking U.S. prices to those in other countries where there are price controls. While they like it in part, some Democrats have said it does not go far enough in lowering prices. The change would only lower prices for physician-administered drugs for people on Medicare, meaning people with private insurance and people getting drugs at the pharmacy counter would not benefit from lower prices. .Medicaid is the largest payer of long-term support services such as home care for the elderly, but states are not required to participate in the home and community-based program. … Continued
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Category Legislative News Page 17
Each year, due to a faulty formula that's used to determine Medicare's reimbursement rates, doctors are threatened with sizable pay cuts. This year, if Congress fails to act, doctors will face a 25 percent cut. Lawmakers consistently override scheduled pay cuts with temporary "fixes," but many doctors have grown tired of the ritual and have stopped treating Medicare patients. The estimated cost of repealing the formula has recently dropped dramatically, and many are hoping to replace it in the coming months. Doing so would provide much-needed stability for Medicare beneficiaries. .Sources: "Preliminary Estimate of the Budgetary Effects of Using the Chained CPI Starting in 2014," Congressional Budget Office, March 1, 2013. .Noting the vast and unprecedented danger that the coronavirus presents to the elderly and people with disabilities, patient advocates described the lack of inspections as a shocking oversight. … Continued
Such logic would be disastrous if it were applied to a successful COVID vaccine. COVID-19 has shut down countless businesses, creating record-high unemployment. And the medical consequences of severe COVID-19 mean weeks of highly expensive intensive care. .Downsizing doctor networks is one way that Medicare Advantage insurers are dealing with the sizable cuts. Some insurers have also begun to increase premiums and out-of-pocket costs that enrollees pay. Austin Pittman, President of UnitedHealth, told the Wall Street Journal: "It's no secret that we are under substantial funding pressure from the federal government … That's what's driving our actions." .He is a member of TREThe Enlisted Association (TREA), The American Legion, the National Association of Uniformed Services (NAUS), the National Rifle Association (NRA), and the United States Flag Foundation. He was a member of the committee that chartered TREA Eagle Chapter 94, Warner Robins, Georgia, in 199He also served as their first President from 1999 to 200In 2001, he moved to Las Vegas, and joined Chapter 84, where he served as their President from 2002-200He returned to Warner Robins 2006, and rejoined Chapter 9He served as their President in 2007 and 2008, 2015, and 201He is still active in chapter activities. .Providing Medicare services is not simple, but it is critical that we continue to make efficient investments in the healthcare expenses of 48 million people and develop an adequate workforce to provide those services. I proudly voted for the Patient Protection and Affordable Care Act (PPACA), which expanded access for Medicare beneficiaries and increased investment in healthcare provider training. I also remain a staunch opponent of attempts to increase costs to beneficiaries and privatize this valuable program. .TSCL's Endorsement Sought for Social Security Bill .Sixty – seven percent of seniors participating in the survey said they already spend up to one-third of their Social Security benefits on Medicare costs. Another 21 percent said they spent up to one-half. "Because healthcare costs are rising more rapidly than Social Security benefits, spending on Medicare takes an increasing share of senior income as seniors age," says Cates. .According to that study, during a recent five-year period, Medicare spending on hundreds of medicines to treat various neurologic conditions, such as epilepsy and multiple sclerosis, rose 50%, but the number of claims increased only 8%. .Proxy voting allows a member of the House to give to another member the right to cast a vote on his or her behalf. The member authorizing the proxy will stipulate how the vote should be cast and the member casting the proxy vote is required to abide by the wishes of the member granting the proxy. .The high cost of treatment is a frequently cited barrier by those who are not getting the dental care they need. Elizabeth H., a retiree living in Colorado told us "I do not have the ,000 I was told that I needed to get my teeth fixed. They need to either be pulled and a bridge put in, or root canaled. Being on a limited income, I do not see getting any of this done, and so it affects my health negatively. Without dental care, I'm not as healthy as I could be."
