News

  • Legislation To Help Notch Victims Is Introduced

    Medicare Advantage plans are booming in popularity with retirees, as a low-cost health coverage alternative. In 2016, the plans cover more than 18 million people, but troubling audits indicate that many plans are overbilling the government for many, if not the majority, of the patients treated. Because overcharges drive up Medicare program spending, the higher costs are shifted to all people enrolled in Medicare through rising Part B premiums— even to people who never enrolled in a Medicare Advantage plan. .Tests are underway in up to 26 states to move as many as 3 million "dual eligibles" — people who receive both Medicare and Medicaid — into managed-care health plans. .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." … Continued

  • Legislative Update For Week Ending February 8 2013

    The age at which you should start Medicare Part B is still 6Failure to enroll on time can expose you to permanent delayed enrollment penalties, not only for Medicare Part B (doctors and outpatient services) but also for Part D (prescription drug coverage). These penalties which can add 10% - 12% per year respectively to your Part B and Part D premiums for every year you miss enrollment deadlines, for the rest of the time you have Medicare. .The Bureau of Labor Statistics (BLS) the agency within the Department of Labor that gathers information about prices that consumers pay in order to determine the inflation rate, and therefore the COLA for next year, has let it be known that because of the virus they are going to have to estimate some of the costs of goods and services instead of finding out what they actually are. .Cut back spending. Given that housing represents more than one-third of their expenses, older Americans might look for ways to free up the equity in their homes by downsizing or taking out a reverse mortgage, or find ways to cut their costs by exploring options such as home-sharing. … Continued

Sources: "Draft MedPAC Language Calls For Medicare Benefit Redesign," John Reichard, CQ HealthBeat, March 8, 201Medigap Reform: Setting The Context, Kaiser Family Foundation, September 2011. .How much are you spending on prescriptions? Be sure to take TSCL's 2019 Senior Survey and let us know. TSCL is working with Members of Congress to enact legislation that would allow Medicare to negotiate drug prices and supports bills that would cap or reduce out-of-pocket spending. .Nineteen percent (19%) have postponed filling one or more prescriptions due to quarantine or emergency orders to stay home. .This week, lawmakers returned to Capitol Hill following a two-week spring recess and quickly began working on legislation to fund the federal government past Friday, April 28th. At the time of writing this week's update, a continuing resolution (CR) had not yet been adopted by either chamber, but votes are expected by Friday evening. .Senate Adopts Budget Resolution .On Wednesday, the Senate Finance Committee held a hearing to discuss improvements to the Medicare payment system. Currently, reimbursements are determined by the SGR, a flawed formula that regularly calls for steep pay cuts to physicians and threatens seniors' access to medical care. Lawmakers on both sides of the aisle have expressed a strong interest in repealing and replacing the formula in the coming months. .Only two weeks remain before the March 31st deadline, and at this point, it appears as though a temporary "doc fix" will be necessary. Sen. Hatch mentioned on Tuesday that lawmakers are currently considering a nine-month pay patch, which would mean that lawmakers wouldn't have to revisit the issue until after the November elections. Should lawmakers fail to reach an agreement on either a temporary or a permanent solution, doctors who treat Medicare patients will see a 24 percent pay cut, which would negatively impact seniors' access to quality medical care. .Not only does this put unwitting retirees' Medicare number in the hands of crooks who can then resell it to be used to file more false claims, but it can cause Medicare to deny future coverage for genetic testing when it's really needed, because the patient's record will show the test has already been performed. .Much of the debate over federal deficit reduction plans has been focused on overhauling Medicare and making changes to Social Security. But a major funding change is also under consideration for Medicaid, the federal and state program that covers medical care for lower-income individuals including seniors who also receive Medicare. As federal and state governments struggle to address Medicaid funding shortfalls, TSCL is concerned that Notch Babies, and the families who provide care for them, would be among those who would be hit the hardest by funding cuts.