News

  • Medicare Tops U S Healthcare Lags Nations

    The Centers for Medicare and Medicaid Services (CMS) has estimated that it improperly paid .1 billion to Medicare Advantage plans in 2013 alone. Yet the plans are rarely forced to repay the money they have overcharged, or face closer government scrutiny after the audits, according to the Government Accountability Office (GAO). The GAO report said that CMS has failed to target health plans with "known improper payment risk", allowing the worst abusers to avoid scrutiny. .The Affordable Care Act made changes that slowly close the doughnut hole, but it's a lot like trying to fill a bathtub when the drain is still open. In 2017, those who fall into the coverage gap will have lower coinsurance, paying 40% of brand-name prices and 51% of generic prices. In 2018, those numbers will fall to 35% and 44%, respectively. And in 2020, they will be responsible for the standard 25% of the costs of both brand-name and generic drugs. However, beneficiaries will continue to be saddled with an ever-growing out-of-pocket maximum that must be paid before catastrophic coverage begins. Over the next eight years, that maximum will grow from this year's ,850 to ,300 in 2024. .Industry groups and health systems led by the American Hospital Association challenged the rule, arguing that the rule would do more harm than good because it won't "tell consumers their actual out-of-pocket costs, will likely produce confusion and may be less effective than the price-transparency tools the hospital field has been developing." … Continued

  • Legislative Update Week Ending October 7 2016

    Despite the efforts of TSCL and others, knowledge of the U.S – Mexico Totalization Agreement remains limited on Capitol Hill, and the issue flies under radar for the most part. TSCL has expressed its support for resolutions in opposition to the totalization agreement. In addition, TSCL is supportive of legislation, such as the Social Security Totalization Agreement Reform Act, which would grant more time for congressional review of these agreements. TSCL also supports loophole-closing legislation which would prevent individuals who worked in the U.S. while illegal from receiving credit for that work for purposes of Social Security benefit calculations. .Help! Mom Moved In With Us, But Her Medicare Plan Isn't Accepted Here! .In addition, three new cosponsors signed on to the Preventing and Reducing Improper Medicare and Medicaid Expenditures (PRIME) Act (S. 1123 and H.R. 2305) this week, bringing the total up to twenty-four in the Senate and thirty-four in the House. If signed into law, the comprehensive bill would take a number of steps to prevent fraud, waste, and abuse within the two programs – a problem that TSCL believes must be addressed in order to ensure that scarce program dollars are being spent properly. The new cosponsors are Sen. Sheldon Whitehouse (RI), Rep. Carol Shea-Porter (NH-1), and Rep. Jackie Speier (CA-14). … Continued

If it has been less than 2 weeks since your shot, or if you still need to get your second dose, you are NOT fully protected. Keep taking all prevention steps until you are fully vaccinated. .The traditional formula does not take into account rising Medicare premiums, deductibles and expenses for prescription drugs that have had increasing effects on this segment in recent years. The revised formula accounted for 15.9 percent of seniors 65 or older living in poverty, which nearly doubled the percentage used in the traditional formula. In total, a record level of 49.1 million Americans are considered in poverty, according to the new estimates. .Rapidly climbing prices for consumer goods and services are making financial choices for older adults especially challenging this year. But eventually, these higher prices might mean a higher Social Security cost of living adjustment (COLA) for next year. In the meantime, older consumers are struggling to figure out how to pay for. Buying Power of Social Security Benefits Wiped Out by Soaring Inflation An abrupt jump in inflation in February and March of this year wiped out a short-lived improvement in the buying power of Social Security benefits in 2020, according to TSCL's latest study on rising senior costs. The study, which compares the growth in the Social Security cost of living adjustments (COLA)s with increases in the. Are We Experiencing the Return of Inflation? , editor .That represents a huge liability to the Social Security Trust Fund, should there be an amnesty. Every year the SSA processes millions of W2s. When a name or SSN on a W2 doesn't match the SSA's records, the wage report goes into an "Earnings Suspense File" (ESF) until the discrepancy can be reconciled. The ESF file today contains more than 312.7 million wage items representing 5 trillion in wages. Wages are what the Social Security Administration uses to determine entitlement to Social Security, rather than the amount of taxes paid. Immigration reform advocates say that although payroll taxes are withheld from the checks of illegal workers, they have little chance of collecting benefits. .Not necessarily. According to a new audit report by the Social Security Administration's Office of Inspector General, more than 26,000 beneficiaries receiving spousal benefits may be eligible for a higher retirement benefit based on their own earnings, but are not receiving them. Although the Social Security Administration sends notices to widows and widowers who may be eligible for a higher retirement benefit based on their own earnings at full retirement age, and age 70, it does not provide similar notices to spouses who may also be eligible for higher retirement benefits based on their own earnings. .So, before these invaluable vaccines hit the market, we should talk about an actual price. Otherwise, we will be stuck paying dearly for shots that the rest of the world will get for much less. .The measure has bipartisan backing in the Senate, as well as support from some moderate House Democrats. However, it is facing opposition from House leaders who say the legislation is a roundabout way to cut Social Security benefits. .That's because the small increase would equal only an extra a month for someone getting a ,000 check, based on estimates released last week. And that's after Social Security recipients saw no raise at all for 2016 — only the third time in four decades that has happened. The final figure for 2017 should be released in the fall. .Social Security Subcommittee Examines Information Technology