Category

Medicare

Protect Yourself From COVID-19 Scams

You may already be taking steps to protect your health during the COVID-19 emergency. Be sure to also protect your identity from scammers by guarding your Medicare Number.

It’s easy to get distracted and let your guard down during these uncertain times. Scammers may try to steal your Medicare Number. They might lie about sending you Coronavirus vaccines, tests, masks, or other items in exchange for your Medicare Number or personal information.

Protect yourself from scams:

  • Only share your Medicare Number with your primary and specialty care doctors, participating Medicare pharmacist, hospital, health insurer, or other trusted healthcare provider.
  • Check your Medicare claims summary forms for errors.

More Info

Visit Medicare.gov/fraud for more information on protecting yourself from fraud and reporting suspected fraud.

Sincerely,

The Medicare TeamNote: You can learn more about COVID-19 and your Medicare coverage on Medicare.gov.

Dental Information For Those On Medicare

Oral Health

The House of Representatives passed H.R. 3, a bill that would lower prescription drug prices and use the savings to add an oral health benefit to Medicare. If you have questions on what a Medicare dental benefit would entail, check out our FAQ about adding an oral health benefit to Medicare Part B. You can access earlier oral health resources on this topic. The Miami Herald also published a story about the difficulties older Florida residents facebecause of a lack of oral health coverage.

 

Medicare 101 Made Easy

Learn About Medicare

If you will be entering the Medicare program or have been on Medicare already and would like to use your benefits, it can be over whelming.

Deciding when do I apply for Part A, Part B, Part C & Part D.

What does it all mean? Your choices about your health care is very important and to make an educated decision can be confusing.

Come to explore what your options may be and get answers to questions you may have. There are several meetings scheduled.

Events

Saturday, October 12th – 11am to 12pm

Ridgefield Public Library
527 More Avenue
Ridgefield, NJ 07657

Thursday, October 17th – 1:30pm to 2:30pm

Saddle Brook Library
340 Mayhill Street
Saddle Brook, NJ 07663

Saturday, October 26th – 4pm to 5pm

Hawthorne Public Library
345 Lafayette Avenue
Hawthorne, NJ 07506

Saturday, November 2nd – 11am to 12pm

Ridgefield Public Library
527 Morse Avenue
Ridgefield, NJ 07657

Saturday, November 21st – 6pm to 7:30pm

Hawthorne Public Library
345 Lafayette Avenue
Hawthorne, NJ 07506

Download The Event Times Here

Fraud Alert – Genetic Testing Medicare Scam

Have you heard about the latest scam? Scammers are offering “free” genetic tests and claiming Medicare will cover it — so they can get your Medicare Number and use it to commit fraud and identity theft. They’re targeting people through telemarketing calls, health fairs, and even knocking on doors.

Only a doctor you know and trust should order and approve any requests for genetic testing. If Medicare is billed for a test or screening that wasn’t medically necessary and/or wasn’t ordered by your doctor, the claim could be denied. That means you could be responsible for the entire cost of the test, which could be thousands of dollars.

Learn more here

Re-admissions penalty doing little to slow the spinning of hospitals’ revolving doors

Author of original content: Jeff Lagasse
Original article found here.

Every American hospital has two front doors: The real one, and an imaginary revolving door. Any patient who winds up back in the hospital within a few weeks of getting out travels through that imaginary door, and the more of them there are, the more money the hospital stands to lose from the Medicare system.

This readmission penalty aims to spur hospitals to prevent unnecessary costly care, but a new study shows that after several years of rapid improvements in re-admissions, the readmission penalty program may be spinning its wheels more than it’s slowing the spinning of the revolving hospital door.

Writing in the journal Health Affairs, a team from the University of Michigan reported findings from their analysis of data from nearly 2.5 million Medicare patients. They focused on those who had hip or knee replacement surgery before and after penalties affecting these operations were announced.

The study shows the readmission rate for these patients had already started dropping by the time the idea of readmission penalties was announced as part of the Affordable Care Act in 2010. Soon after that, the re-admissions rate for these surgical patients started dropping faster — even though the penalties announced in the ACA did not apply to surgical patients.

The rate kept dropping rapidly for several years — even though hospitals weren’t getting penalized yet for hip and knee replacement-related re-admissions. But that improvement started to slow down.

After the government announced in late 2013 that penalties would expand to hip and knee replacement, the rate of re-admissions for these patients kept dropping, but at nearly half the rate. In other words, improvements in surgical re-admissions slowed to the same pace they had before any penalties were announced in 2010.

WHAT’S THE IMPACT

At the same time the readmission rates were changing, the average cost of caring for a Medicare hip or knee replacement patient did too, the study showed. In fact, it dropped by more than $3,000 from 2008 to 2016.

And hip and knee patients’ chance of heading home from the hospital, rather than to a skilled nursing facility or other setting, has increased over that time. So has the likelihood that they will have assistance from a home health aide when they get home.

The authors contend that the same efforts that hospitals may have launched to prevent readmission of medical patients may have extended to these surgical patients. These might include care coordination programs and phone check-ins with recently discharged patients, or better patient education about home care or changes to their medications.

The Hospital Readmission Reduction Program, or HRRP, still carries large penalties — up to 3% of what a hospital earns for certain Medicare patients. It has also expanded to include more conditions, including heart bypass surgery and more types of pneumonia, including those with sepsis.

But researchers say that adding more conditions to the program is not likely to result in much more readmission prevention or cost savings.

In the end, some re-admissions are inevitable, they said, and trying to drive rates lower through penalties may mean some patients who should have been readmitted won’t be.

Instead, the authors suggest that more use of bundled payments — where Medicare sets a defined amount of money it will pay for the episode of care surrounding a surgical patient’s operation — could produce better results. This is because bundled payments ensure hospitals focus on costs and complications around the entire episode of care, not just one metric like re-admissions.

THE LARGER TREND

There’s been ongoing debate regarding the equity of the HRRP. For example, safety net hospitals have long held they are unfairly penalized for their readmission rates under HRRP’s current performance model because it doesn’t account for social risk factors that put these patients at risk for readmission.

Medicare Part B Fairness Act Introduced

Representatives Katie Hill (D-CA-25) and Brian Babin (R-TX-36) recently introduced The Medicare Part B Fairness Act (H.R. 1788). The bill would limit the amount and duration of the Part B Late Enrollment Penalty (LEP). As well as expand the Special Enrollment Period for people with employer-sponsored coverage to other types of pre-Medicare coverage.

To amend title XVIII of the Social Security Act to limit the penalty for late enrollment under part B of the Medicare Program to 15 percent and twice the period of no enrollment, and to exclude periods of COBRA, retiree, and VA coverage from such late enrollment penalty.

Bills Introduced to Protect Medicare Beneficiaries from Observation Status Coverage Gap

Last week, bipartisan, bicameral legislation was introduced to ensure all Medicare beneficiaries who spend three days or more in a hospital can access post-acute care in a Skilled Nursing Facility (SNF) when they need it. Currently, Medicare can deny SNF coverage following a hospital stay classified as outpatient observation rather than inpatient. The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682S.753) would protect beneficiaries from surprise bills for skilled nursing care by counting time they spend in observation status toward Medicare’s three-day stay requirement. Are you hospital inpatient or outpatient?

Click here to see the PDF

How to find and compare hospitals

When you’re comparing hospitals, look for one that:

  • Has the best experience with your condition.
  • Participates in Medicare and is covered by your health plan.
  • Checks and improves the quality of its care.
  • Performs well on quality measures, including a national patient survey.
  • Meets your needs in terms of location.

Click link – View Medicare Website

 

Learn About Medicare Parts A, B, C & D

Join us at Louis Bay public library in Hawthorne, NJ. Bring your questions and thoughts. Free event Saturday, March 23rd, starts @ 11 AM.

If you will be entering the Medicare program and would like to use your benefits, it can be over whelming. Deciding when do I apply for Part A, Part B & Part D.

Your choices about your health care coverage is very important and to make an educated decision can be confusing. Come to explore what your options are and get your questions answered.

Medicare 101 Parts ABCD