Medicare News Blog

In a recent letter to Center for Medicare and Medicaid Services (CMS) Administrator Mark McClellan, MD, PhD, Iowa Senator Charles E. Grassley, Chairman of the Senate Finance Committee, wrote that procedures being done at the nation’s Ambulatory Surgical Centers (ASCs) “would greatly reduce overall Medicare spending.” Medicare Regulation §416.41 states “ The ASC must have [...]

“Removing the permanent late enrollment penalty will encourage Medicare beneficiaries who currently don’t have drug coverage to enroll in Part D at the next available opportunity,” said AARP Arizona State Director David Mitchell. “It’s also important to note that some Arizonans can enroll today without penalty if a person qualifies for a Special Election Period [...]

The variety in companies and difference in plans is where the problems arise, and some people didn’t sign up for fear of making the wrong choice. “You want to make it clear and less stressful and it’s not,” Heimberg said. “It’s been challenging for everyone.” “A lot of prescriptions are not covered in their plan [...]

“As a national leader in state healthcare program administration, ACS has a solid record of excellence supporting a full gamut of state and local programs, a depth of program management expertise, and world-class IT capabilities,” said Lynn Blodgett, ACS Executive Vice President and Chief Operating Officer. “CARDS is a vital tool that employers can use [...]

According to the written version of Norwalk’s testimony, “A recent CMS survey found that up to 18 of the top 20 [prescription-drug plans] pay pharmacy claims on a twice-a-month billing cycle of 15 days or less. A 15-day billing cycle generally provides pharmacies with payment within 21-25 days. The top plans account for more than [...]

The Centers for Medicare and Medicaid Services also told insurers on Wednesday that when they market their drug plans to consumers next year, and cite a particular company as a partner, they need to include the phrase “other pharmacies/physicians/providers are available in our network.” “It never occurred to us that would be an issue until [...]

“Medicare‘s prescription drug benefit holds great promise for improving seniors’ lives by increasing access to medications,” said NCQA President Margaret E. O’Kane. “But we need to make sure that the promise of the benefit isn’t undercut by the possibility of medication errors. This paper highlights a great opportunity to collect and report data that can [...]

“It’s saving lives, and it’s saving money,” Representative Phil Gingrey, Republican of Georgia, said last week at a rally on Capitol Hill, celebrating “the unprecedented success of Medicare Part D.” Senator Jim Talent, Republican of Missouri, said many constituents had told him, “This is a godsend.” Democrats say that the benefit is skimpy, that the [...]

With its troubled launch and frantic final enrollment drive now history, the Medicare prescription-drug program is bracing for what could be its most significant public-relations hurdle yet. In coming months, millions of older Americans and people with disabilities will face a lapse in coverage known as the “doughnut hole” once their annual drug spending hits [...]

Medicare officials said they are unlikely to extend a long-running suspension on Medicare payments to new physician-owned specialty hospitals beyond Aug. 8, opening the way for development of new limited-service hospitals. Although specialty hospitals in the Wichita area were not directly affected by the payment suspensions, local health care providers are watching the ongoing debate. [...]

“The guidelines are much broader than people think,” she said. “The system is set up to help people.” The state used different techniques in North Georgia than in metropolitan areas, she said. “We did a lot of newspaper outreach in rural areas, as well as radio and TV,” she said. “We also targeted homebound individuals, [...]

The result of adopting the new codes would be to bring the nation`s healthcare system into the digital age instead of relying on codes developed in the 1970s, Johnson said when she introduced the bill last year. ‘It will overcome some of the key obstacles that have slowed our progress toward adoption of a national, [...]

Leavitt praised the six-month enrollment process, which ended at midnight Monday, as “a remarkable American moment . sort of a de Toqueville moment.” Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services, said the program is a “historic success.” “We’re dealing with a whole brand-new program,” Grassley said. “We want to give [...]

“What is true, is absolutely true, is that seniors are saving a lot of money,” she said. “It’s lifting burdens off the back of retirees to a degree never imagined.” “I really think it’s a cruel thing to penalize people for what has been admittedly a very complex procedure in order to get the drugs,” [...]

“They needed that deadline or they wouldn’t sign up,” Health and Human Services Secretary Mike Leavitt said Sunday. “In fact, the actuary for the government told us if we didn’t have a deadline, 1.6 million people fewer would actually sign up.” Medicare Part D got off to a rocky start in January, when at least [...]