News

  • Ask The Advisor February 2013

    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. .In 1996 Congress passed legislation barring felony fugitives from receiving SSI benefits. A new computer program should end such payments while helping law enforcement officers to track down fugitives. Computers match law enforcement records against the data files of beneficiaries of SSI and other Social Security programs. When a match is found, SSI benefits can be terminated, and investigators can provide law enforcement officials with the fugitive`s most recent address where he or she has been receiving checks. .The Medicare Hospital Trust Fund is Running Out of Money … Continued

  • Legislative Update For Week Ending June 8 2012

    Thus beneficiaries will continue to be hit with steep costs when they fall into the coverage gap in the foreseeable future. To keep prices as low as possible in the doughnut hole, beneficiaries can look into using mail-order pharmacies, which require 90-day prescriptions and are often cheaper per dose than a 30-day supply. People with limited incomes may also qualify for Extra Help or other pharmaceutical assistance programs. TSCL also recommends that Part D beneficiaries talk to their doctors at each visit to discuss potential alternatives to their high-cost prescriptions. .What you can do: Public opinion can sway votes in Congress! Take TSCL's 2012 Senior Survey. TSCL will publicize the results and share your comments with elected lawmakers in our visits to Capitol Hill. .On Thursday, the House Ways and Means Social Security Subcommittee held a hearing to discuss the findings of the new 2018 Social Security Trustees Report. Those on the subcommittee heard from Stephen Goss, Chief Actuary at the Social Security Administration. … Continued

Some issues of controversy inevitably arose at Thursday's hearing, but common ground was also found on the important issue of corporate tax reform. The Joint Committee, which must hold a vote on its final proposal before Thanksgiving, will likely hold a third public hearing in the coming weeks. TSCL will continue to monitor its progress. .How the Coronavirus Pandemic Is Affecting the Finances of Older Households .Bloomberg also said the administration is still moving forward with the plan and that the cards will likely be sent in November or December. .The Health and Human Services Department finalized the policy through an interim final rule in November, meaning the agency skipped the comment period. Lowering drug costs for patients is the end goal of the policy, which the government argues justified the speedy implementation. .Catastrophic Coverage Period: When your total out-of-pocket spending reaches ,350, you hit the catastrophic stage of coverage. Your co-insurance drops to 5% coinsurance or co-pays of .60 generic, .95 brand, whichever is higher. You remain in the Catastrophic coverage period until December 31, 2020. .Rep. Peter DeFazio (OR-4) introduced H.R. 1031 on March 7, 201It has since been referred to the Committee on Ways and Means and the Committee on the Budget. .By Representative Tim Walberg (MI-7) .Worst of all, patients don't qualify for Medicare coverage of follow-up nursing home care, because Medicare requires three consecutive days in the hospital as an "inpatient." That leaves the patient and their families on their own to figure out how to pay nursing home bills, or to go without. .The "house calls" can be money-makers for health plans when they document medical problems like complications from diabetes or heart trouble. Health plans profit because Medicare pays higher rates for sicker patients using a billing formula based on the patient's "risk score." Plans can receive thousands of dollars in higher payments from Medicare even though the insurer incurs no additional costs for covering Medicare services for your brother.