Medicare to Docs: Go Electronic in 2012

Medicare, the federal health insurance program for the elderly and disabled, will offer financial bonuses to doctors who prescribe drugs electronically rather than on paper. Doctors who do not will face penalties from Medicare starting in 2012. From Reuters. Medicare states that this is to improve efficiency between doctors and pharmacies and to avoid problems with handwriting, patients who lost prescription notes, etc. However, how much is this going to cost doctors--especially those who are serving low income areas or who are in private practice? I understand that Medicare is now offering monetary incentives to doctors who welcome this program but why bribe doctors into doing something that they will already ahave to do in a few years. Medicare should, if they are mandating that doctors adhere to this new policy, spend money to educate docs and their staff on the new inititative.

Just the Essentials: Deciding on Medicare Coverage

We stumbed across this very informative piece this morning by Allsup on MarketWatch that details the 10 most important things that indivudals/caretakers must ask themselves when figuring out appropriate Medicare coverage. The article stresses that knowing one's healthcare needs is the key to understanding what plans are solid for their needs. We highly recommend that you print out this list, available here.

U.S. Nursing Homes Get "Zagat" Rated by Feds

For a listing of the ratings by state, please click here. By offering ratings to each nursing home, it gives a clear rating of the quality of the home. Though a visit is always encouraged, soon people would be able to choose a nursing home much like choosing a place for vacation. What is particularly interesting about this report is that non-profit oranizations take better care of their clients than for profit organzations. This is probably because non-profits are so tied into keeping their non-profit status that a system of checks and balances in high order. An analysis of nearly 16,000 nursing homes reveals for-profit homes are more likely to provide inferior care than their non-profit rivals, according to a USA TODAY examination of the federal government's first ratings of the homes' performance. The new Zagat-like rating system, released today by the Centers for Medicare & Medicaid Services, assigns homes one to five stars for quality, staffing and health inspections, plus an overall score. What do you think of the rating system? How will it affect U.S. nursing homes?

Brand-Name Drugs are Favored by Medicare Beneficiaries

According to this article in EmaxHealth, brand-name medications account for almost two-thirds of all prescriptions filled by Medicare beneficiaries. Patients are asking for brand-name drugs when the program provides coverage and are asking pharmacists for generic drugs when they have to pay out of pocket.

When patients switch from brand-name to generic drugs, more than likely they’ve reached the coverage gap in which they must cover the full cost of the prescriptions. Woody Eisenberg, Medco Chief Medical Officer mentions that when Medicare beneficiaries become aware of the coverage gap they "become acutely aware of the cost difference between brand-name and generic drugs and most make the switch."

Texas Medicaid Fraud

Oops! More kickbacks for health officials have landed Texan health officials in some serious hot water. What is important about this case, as with all fraud cases, is that it affects the individuals who trusted in others to do their job and to do it well. People don't want to be seen as dollar signs, it grows contempt in the consumer which is just bad business. This case, with phony advocacy groups and false marketing materials is predatorial and wrong and these individuals deserve to be prosecuted by the full extent of the law. J&J’s Janssen Pharmaceutica funneled kickbacks to Texas health officials, distributed false marketing materials and deployed phony advocacy groups to get its Risperdal antipsychotic prescribed to low-income Texans, the state alleges in a new filing in an ongoing fraud lawsuit filed in 2006, according to The Dallas Morning News

Medicare assures patients about access to oxygen

From AP: Medicare officials tried on Monday to quell growing worry by the elderly that they could lose access to lifesaving oxygen supplies with the start of the new year. With a rise in phony marketing scams, which this blog has covered, many less than reputable companies are preying on the elderly for more money to offset their own losses during this economic climate. We must assure people that Medicare, though wacky and seemingly mismanaged will not keep individuals from life saving access to medical supplies. Any individual representing a company that claims to do so is wrong. Always do background checks on any company or individual who contacts you our someone you know about your personal Medicare status. For the rest of this article, please click here.

DaVita gets Department of Health subpoena for documents related to Medicare practices

From CNN/AP
Dialysis services company DaVita Inc. said Monday it is responding to a Department of Health and Human Services subpoena for documents related to Medicare claims for several drugs.
What do you think will come out of this government audit of DaVita? DaVita has willingly given up all of their documentation and files regarding Medicare claims, so perhaps they have nothing to hide. We'll keep you posted on any new developments. For the rest of this article, please click here.

First Spanish Medicare Educational Video for Seniors Released

From MarketWatch:
Award-winning journalist Maria Antonieta Collins has partnered with UnitedHealthcare to create the first-ever Spanish-language Medicare educational DVD for seniors and their caregivers.
What do you think of this outreach to the elderly Latin community?
For more information and for the video, please click here.

AP: Medicare insurers' profits exceed expectations

Health insurance companies that serve the elderly and disabled in Medicare are realizing significantly higher profits than they anticipated, resulting in the companies getting $1.3 billion more than projected, congressional auditors say.

This is likely due to an increase in payments to companies by the elderly, without an increase in services by the organizations. This money is now being seen as a profit that the companies in question must diligently work with the government to make sure that the clients served via Medicare are getting the best care that they deserve. We'll keep you posted on any new developments.

For the rest of this article, please click here.

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! For a direct link to this article, please click here.

Indiana: Beware of Medicare scams

Everyone should be on the look out for Medicare fraudsters out to get money from unsuspecting seniors. Medicare does not contact seniors to go over their health care benefits and medicare does not schedule time to visit with seniors in their homes. If you or someone you know has been contact by a source claiming to help out with Medicare, let the authorities know immediately. For an example, please click here.

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.

For the rest of this article, please click here.