News

  • Weekly Update For Week Ending July 31 2020

    Covid-19, for which there is neither a sure treatment nor vaccine, has created a perfect storm for fraudsters interested in preying on people who are vulnerable, frightened, and isolated. Their scams employ typical tactics of the defrauder's trade: empty promises of protection against a sometimes-fatal disease. .Prior to 1984, Social Security benefits were excluded from taxation. Today, from 50 to 85 percent of Social Security income can be subject to taxation depending on two income thresholds. For taxpayers with incomes between ,000 and ,000 (individual) or ,000 and ,000 (filing jointly), up to 50 percent of Social Security benefits may be taxable. For individuals with incomes above ,000 or couples filing jointly with incomes above ,000, up to 85 percent of benefits may be taxable. .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." … Continued

  • Category Legislative News Page 29

    Fraud, waste and abuse are costing taxpayers and seniors an estimated billion a year, but Medicare fails to recover overpayments about 80 percent of the time. The Inspector General recently said that of the 6,287,546 in overpayments identified through the 30-month period ending March 31, 2009, the Centers for Medicare and Medicaid Services (CMS) reported collecting only ,168,50But it gets even worse. The OIG said that it could not verify that the ,168,502 had been collected as reported because CMS did not have an adequate system for documenting overpayment collections. .This week, lawmakers in the Senate held confirmation hearings to question Congressman Tom Price (GA-6) and Congressman Mick Mulvaney (SC-5), who have been nominated by President Donald Trump to fill important positions in the administration. .The Notch Could Happen Again … Continued

The expert witnesses at the hearing focused their suggestions on improving the marketplace. Edmud Hailsmaier – Senior Research Fellow at The Heritage Foundation – said policymakers should change how they see the individual market. He said it should be thought of as two distinct pools which include (1) individuals wishing to be protected against the financial liability of large health expenses, and (2) those who are very sick and have no other insurance options. .For progress updates or for more information about these and other bills that would strengthen Social Security and Medicare programs, visit the Bill Tracking section of our website or follow TSCL on Twitter. .Candidates campaign for office saying they don't support cutting Social Security benefits of current retirees, or those close to retirement. Yet the two recently - enacted changes went into effect almost immediately after passage. People who are under the age of 66 by the end of April 2016 may no longer use file and suspend, and those who were under the age of 62 by the end of 2015 will no longer be able to use restricted applications for spousal benefits. .Source: "Audits Of Some Medicare Advantage Plans Reveal Pervasive Overcharging," Fred Schulte, Center For Public Integrity," NPR, August 29, 201"Medicare Advantage: Fundamental Improvements Needed in CMS's Effort to Recover Substantial Amounts of Improper Payments, Government Accountability Office, April 2016. .TSCL agrees with Rep. Johnson, and we believe Congress must begin formulating a serious plan to fix the program's finances. Recently, we announced our support for two pieces of legislation that we believe are long overdue. One bill (S. 499 / H.R. 918) would prevent beneficiaries from collecting both unemployment benefits and disability insurance benefits at the same time. The second bill (S. 1198 / H.R. 1936) would ensure that evidence from convicted felons and other criminals is excluded when determining whether an individual is eligible for disability benefits. .Five Bills Gain Support .TSCL would like to remind you that Members of both the House and the Senate will remain in their home states and districts until Monday, September 10th. We encourage you to contact your Members of Congress to request their support for fair cost-of-living adjustments, Notch fairness, and other issues affecting seniors. .Here's how the coverage gap works. Once individuals and their Medicare Part D plans spend the initial coverage amount (,310 in 2016) on covered prescription drugs in a calendar year, beneficiaries hit the doughnut hole. Once in the doughnut hole, coinsurance on covered drugs is not only higher, one must also pay a substantial amount out-of-pocket to reach the limit for catastrophic coverage. For brand-name drugs in the coverage gap, individuals are responsible for 45% of the cost, and for generic drugs, they're responsible for 58%. Once out-of-pocket costs for those in the doughnut hole total ,850, catastrophic drug coverage takes effect, and Part D plans pay 95% of prescription drug costs until the calendar year ends. .Last week there was major news concerning Social Security, Medicare, and prescription drug prices – or at least so it seemed. But "the devil is in the details" and we will try to sort it out for you below.