AP: Retired players to get new Medicare benefit

The NFL and its union will pay a combined $100 a month toward the Medicare costs of retired players under a new plan announced Tuesday.


Good for them! I love it when organizations take care of their retirees. Let's hope that more visable organzations follow suit!

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New gun for seniors could be subsidized by Medicare

From The Raw Story:

A New Jersey company says they have gotten federal approval to market a gun to the elderly and hopes to have it subsized by Medicare.Constitution Arms says its Palm Pistol will aid seniors with arthritis who would otherwise have trouble pulling the trigger. The device allows individuals to shoot by squeezing with their thumb.The company's president Matthew Carmel says its "something that they need to assist them in daily living," and has applied to have the gun approved as a Class 1 medical device, the same designation given by Medicare to walkers and wheelchairs.

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Medicare, Social Security Owe Up to $52 Trillion to Current Retirees and Workers

Press Release:

DALLAS, Dec 03, 2008 /PRNewswire-USNewswire via COMTEX/ --

Debts Up To Three and Half Times Greater Than Entire U.S. Economy
If the federal government stopped the Medicare and Social Security programs tomorrow -- collecting no more payroll taxes and allowing no more accrual of benefits -- it would still owe up to $52 trillion to those who have already earned these benefits, according to a new study by the National Center for Policy Analysis (NCPA).
"The numbers are staggering," said Andrew Rettenmaier, an NCPA senior fellow and coauthor of the study. "No one thinks we are going to end these programs," he said, "but if we account for federal obligations the way private pensions and state and local governments are required to, the federal government owes up to $52 trillion (in current dollars) as of today."

To put the numbers in perspective, the size of the entire U.S. economy is $14 trillion. The newly released study determined that: --

An estimated $9.5 trillion is owed to current retirees -- an amount
equal to almost $250,000 per person 65 years of age and older in 2008.

-- Adding the liability owed to those nearing retirement (55 and older)
more than doubles the accrued debt to $20.6 trillion.

-- Adding the benefits accrued by younger workers brings the total to as
much as $52 trillion. The beneficiaries include all retirees, as well as
anyone in the workforce above 22 years of age.

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Economy likely to move up Medicare's insolvency

From WashingtonPost.com:

Federal health officials estimate that the struggling economy will speed up by one to three years the exhaustion of the Medicare trust fund covering hospital and nursing home care.
Trustees for the Social Security and Medicare programs warned last March that the trust fund for Medicare Part A would become insolvent in 2019. But the chief actuary for Medicare said Monday the economy will likely generate less revenue through payroll taxes than the trustees had projected.

Once the trust fund is exhausted, the federal government will continue to pay for hospital care and other services, but it initially would only have enough money coming in to cover 78 percent of estimated costs.

Trustees issue a once-a-year report on the financial conditions for Social Security and Medicare. In the fall, the trustees get an update that tells them what's happening versus what their latest projection indicated. In the latest update, Medicare's top actuary braced the trustees for a deterioration in Medicare's finances.

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NYT: Medicare’s Too Costly Private Plans

From NYTimes.com:

Private health insurance plans were supposed to bring better care and lower costs to elderly patients covered by Medicare. Instead they have increased the cost and complexity of the program without improving care, according to new analyses published by the respected journal Health Affairs. Congress clearly has more work to do to remove unjustified subsidies that prop up many of the most inefficient private plans.

Back in the 1980s, private plans — known as health maintenance organizations — were seen as a savior for Medicare. They could provide the same or better services as traditional fee-for-service Medicare, but because of managed care they could do it at a lower cost. Over the years Congress brought other, less managed private plans into Medicare, and in 2003 the Republican-dominated Congress substantially increased government payments to private plans.


Medicare currently pays the private plans — now called the Medicare Advantage program — 13 percent more on average than the same services would cost in the traditional fee-for-service program. Some of the added payments are used to provide extra benefits for enrollees, like reduced cost-sharing or reduced premiums for such extra benefits as vision and dental care.
The added value averages more than $1,100 a year per patient. Not surprisingly, that makes them attractive to individuals and employers seeking coverage for retirees. It has fueled an explosive growth in enrollments. Almost a quarter of all Medicare beneficiaries, more than 10 million people, are enrolled in private plans.


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Miami physicians sentenced for Medicare fraud

From BizJournals.com:

Two Miami physicians were sentenced to prison on Thursday for their roles in an HIV infusion scheme that defrauded the Medicare program out of $6.8 million.
A Miami federal court judge sentenced Carlos Contreras, 61, to three years and Ramon Pichardo, 58, to four years in prison. They also were ordered to repay $4.2 million in restitution to the Medicare trust fund.
Contreras and Pichardo each pleaded guilty to one count of conspiracy to commit health care fraud. Contreras was owner and a doctor at CNC Medical Corp. in Miami. Pichardo was a doctor there.
Contreras and Pichardo admitted that, between November 2002 and April 2004, they conspired with others to file $6.8 million in false claims to the Medicare program for HIV infusion services that were not provided or medically necessary.

New Rules are Imposed on Medicare Advantage Plan Sales

Yesterday’s article on ModernHealthcare.com discusses that the Centers for Medicare and Medicaid Services have issued compensation requirements for sales agents that sell Medicare Advantage plans and prescription drug plans to Medicare beneficiaries.

Some of the rules include paying compensation to all agents according to fair-market value and adjusted for inflation for similar products in the same geographic area. To make sure that everyone is compliant with the new rules, agents will have to CMS their compensation structures for the previous three years as well as the compensation structure they are implementing for 2009.

Medical News Today: MedPAC Adopts Recommendations To Improve Transparency Of Financial Ties Between Industry, Physicians

The Medicare Payment Advisory Commission on Thursday adopted five recommendations to Congress that would require disclosure of the health care industry's financial ties to physicians and other health care professionals, CQ HealthBeat reports. MedPAC will present the recommendations to Congress in March. According to the recommendations:

• Congress should require all manufacturers, distributors and their subsidiaries to report to HHS financial relationships with physicians, pharmacists, pharmaceutical benefits managers and their employees, as well as with hospitals, medical schools and medical or health organizations;
  
  
• Congress should direct the HHS secretary to post the information on a public Web site;
  
  
• All details regarding no-cost drug samples provided to physicians should be posted on the Web site so researchers can study the impact samples have on prescribing decisions;
  
  
• Congress should require all hospitals and other entities that bill Medicare for services to "annually report the ownership shares of each physician who directly or indirectly owns an interest in the entity (excluding publicly traded corporations)" and post the information on the Web site; and
  
  
• Lawmakers should require HHS to submit a report on the "types and prevalence of the financial relationships between hospitals and physicians."
  

MedPAC Chair Glenn Hackbarth said, "This is about transparency. It's not about condemnation" (Reichard, CQ HealthBeat, 11/6).

For more information please visit the original article here.

Physicians Receive Medicare Incentive for e-Prescribing

Pizaazz reports in this article that the Centers for Medicare and Medicaid Services have announced an incentive plan for physicians so that providers will receive a 2% bonus on total Medicare charges during 2009 for using qualified e-prescribing system.

According to CMS, providers must use the e-prescribing systems that:
-Communicate electronically with the patient’s pharmacy,
-Remind physicians about cheaper alternatives (if available),
-Provide Medicare formulary information, and
-Alert prescribers about allergies, improper dosing and drug interactions.

Cost of Health Care

In a recent report from the Centers of Medicare & Medicaid Services, they announced that Medicaid spending will grow at a rate of 7.9% over a 10 year period, with the cost estimated at $674 billion in 2017. It was also noted that the growth rate of the economy at 4.8%, and of health expenditures at 6.7% is lower. By 2013 it is expected that this cost will compromise 8.4% of federal budget in comparison to last years cost of 7%. It was noted in this article that

"Health and Human Services Secretary Mike Leavitt said the analysis was a reminder that Medicaid spending is on an unsustainable path that might threaten the health of the nation’s most vulnerable citizens."