dagblog - Comments for "Administration Faces Opposition To Changes In Medicare Prescription Drug Program"

How Proposed Part D Changes

artappraiser — Sun, 09 Mar 2014 19:07:20 +0000

In reply to Administration Faces Opposition To Changes In Medicare Prescription Drug Program

How Proposed Part D Changes Are Playing On Capitol Hill
Kaiser Health News, March 7, 2014

Officials at the Centers for Medicare & Medicaid Services are proposing to remove some drugs from Medicare’s prescription drug plans and limit how many plans insurers can offer. KHN’s Mary Agnes Carey and CQ Roll Call’s Emily Ethridge discuss

Has video, audio and transcript.

President Obama's Budget:

artappraiser — Fri, 07 Mar 2014 06:09:23 +0000

In reply to Administration Faces Opposition To Changes In Medicare Prescription Drug Program

President Obama's Budget: Medicare Means Testing And Lower Drug Costs
Kaiser Health News, Mar 05, 2014

The budget proposal includes a provision to make wealthier seniors in Medicare pay more as well and another to try to drive down the cost of prescription drugs. A rival Republican plan is also expected to propose cuts to Medicare and Medicaid [....]

An round up of 6 news links on topic with summaries.

Yez you got it, I was

artappraiser — Wed, 05 Mar 2014 00:19:44 +0000

In reply to Don't worry, AA. I'm cooled

Yez you got it, I was thinking of you when I wrote that intro to the article. I really really don't want to have to argue for or agin the LA. Times editiorial board opinion. Thank you for the comment, it helps.

Don't worry, AA. I'm cooled

Peter Schwartz — Tue, 04 Mar 2014 23:45:30 +0000

In reply to An editorial offered only

Don't worry, AA.

I'm cooled out about the whole thing.

You do a valuable thing in informing people on difficult topics, and (not that it needs saying or my permission is required) you're fully entitled to speak your mind.

Seriously.

I'm off this train of argument for good. It's tedious and leads nowhere.

An editorial offered only

artappraiser — Tue, 04 Mar 2014 23:20:17 +0000

In reply to Administration Faces Opposition To Changes In Medicare Prescription Drug Program

An editorial offered only because it does a decent job describing the proposed bill, not to support or dispute the LATimes' opinion:

Fixing the way Medicare doctors are paid
A bipartisan bill would replace the program's problematic payment formula.

By The Los Angeles Times editorial board, March 3, 2014

The headline to this piece has been corrected, as explained below.

Republicans and Democrats can't seem to agree on anything related to the 2010 healthcare law, but they may come together soon on a crucial fix to the nation's largest federal healthcare program, Medicare. At issue is the "sustainable growth rate," a mechanism Congress enacted in 1997 to limit Medicare costs. It hasn't; instead, it has simply threatened physicians with ever-larger and more unreasonable cuts in fees, which Congress has routinely waived. Now, the top Republicans and Democrats on three congressional committees have come up with a replacement formula; the only missing piece is a way to pay for it. Although that's a significant issue, it shouldn't stop Congress from adopting the proposal [....]

A minor point, re: cuts in

artappraiser — Tue, 04 Mar 2014 23:07:45 +0000

In reply to Crackdown Proposed to Prevent

A minor point, re: cuts in payments for nursing homes and home health agencies.

I wonder how well that would sync with raising the minimum wage?

Medicare?s Drug Program Needs

artappraiser — Tue, 04 Mar 2014 23:07:02 +0000

In reply to Administration Faces Opposition To Changes In Medicare Prescription Drug Program

Medicare’s Drug Program Needs Stronger Protections Against Fraud, Watchdog Says

A new report finds that more than half of insurance companies in Medicare’s drug program haven’t reported fraud cases to the government. The findings echo an earlier ProPublica investigation that found fraud flourishing in the program.

By Charles Ornstein, Pro Publica, March 4, 2013

Medicare has failed to adequately track fraud in its massive prescription drug program, according to a new report today from the agency’s watchdog.

In particular, the inspector general of the U.S. Department of Health and Human Services found that fewer than half of the insurance companies paid to administer Medicare’s drug program reported data to the federal government about potential fraud and abuse cases between 2010 and 2012. Two large insurers with 4 million members collectively appear not to have reported a single incident of fraud in 2012.

Medicare didn’t follow up, the inspector general found, and officials did little with the data they did collect [....]

Crackdown Proposed to Prevent

artappraiser — Tue, 04 Mar 2014 23:00:02 +0000

In reply to Administration Faces Opposition To Changes In Medicare Prescription Drug Program

Crackdown Proposed to Prevent Illegal Immigrants From Obtaining Medicare
By Robert Pear, New York Times, March 3/4, 2014

[....] In President Obama’s budget for 2015, to be unveiled on Tuesday, and in new regulations, the administration proposes to remove illegal immigrants from the Medicare rolls and explicitly require citizenship or lawful presence in the United States as a condition of getting Medicare.

Under a 1996 law, the administration said, immigrants are generally ineligible to receive federal benefits if they are “unlawfully present in the United States.” But, officials said, many illegal immigrants have received benefits because the Medicare agency did not update its rules or policies to carry out the restrictions imposed by Congress.

In his budget, expected to total roughly $3.8 trillion, Mr. Obama steers clear of structural changes in social welfare programs, which make up about 60 percent of the budget. But he proposes substantial savings in Medicare, including cuts in payments for nursing homes and home health agencies.

Although Medicare costs have been growing slowly in recent years, the number of beneficiaries is expected to grow 35 percent in a decade, to 70 million in 2024. And the cost of Medicare drug benefits is expected to shoot up to $170 billion, from $70 billion this year.

The administration said its proposal to have illegal immigrants “involuntarily disenrolled” would save at least $67 million over five years, mainly by requiring private Medicare Advantage plans and prescription drug plans to deny or revoke coverage for people who are in the country illegally [....]

Plus it has numbers. and

Resistance — Tue, 04 Mar 2014 03:39:24 +0000

In reply to The following recent Kaiser

Plus it has numbers.

and footnotes thanks AA

The following recent Kaiser

artappraiser — Mon, 03 Mar 2014 19:40:22 +0000

In reply to Administration Faces Opposition To Changes In Medicare Prescription Drug Program

The following recent Kaiser Health News article is the best one I have ever seen for

1) summarizing what is covered by Medicare and what is not and what might be done to change that

2) how the Medicare Modernization Act of 2003 (MMA) and the implementation of the Medicare drug benefit in 2006 introduced what might be called "means testing" into the system

and most importantly, something that I have found really hard to find

3) giving the actual numbers of how Medicare recipients are covered for what is not covered by Medicare

Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges
By Juliette Cubanski, Tricia Neuman and Zachary Levinson, Feb. 27, 2014

[...] Under the current cost-sharing structure of traditional Medicare, there are separate cost-sharing requirements for services covered under Medicare Parts A and B that vary by the type of service, with no limit on annual or lifetime out-of-pocket spending. The traditional Medicare program provides less generous coverage on average than typical large employer health plans—including the most common plan offered under the Federal Employees Health Benefits Program (FEHBP)—largely due to Medicare’s relatively high Part A deductible, the lack of a spending limit for Part A and Part B services, and less generous drug coverage.¹

Most people with Medicare have some type of supplemental insurance to help cover Medicare’s cost-sharing requirements. In 2010, more than a quarter of beneficiaries enrolled in traditional Medicare (26%) had a Medigap policy as a source of supplemental coverage and 40 percent had an employer-sponsored supplemental plan (these numbers include the 5 percent of beneficiaries with both types of coverage).² More than one fourth of the Medicare beneficiary population is enrolled in a Medicare Advantage plan rather than traditional Medicare, such as a Medicare HMO or PPO, and all Medicare Advantage plans are required to include a limit on out-of-pocket spending.³ Additionally, nearly 10 million low-income beneficiaries are enrolled in Medicaid and receive help paying Medicare’s premiums and/or cost-sharing requirements.⁴

Prior to the enactment of the Medicare Modernization Act of 2003 (MMA) and the implementation of the Medicare drug benefit in 2006, Medicare’s cost-sharing obligations applied uniformly to all people on Medicare without regard to beneficiaries’ income [.....]

If you are nearing Medicare age and do not understand Medicare that well, I cannot recommend this article enough for getting the gist of it. There are things in here that took me a gazillion hours of digging deep into CMS gobbleygook and congressional bills and the like to figure out. Plus it has numbers.