May 22, 2013

Industry Seeks Savings from Medicare Beneficiaries

Members of the Healthcare Leadership Council—which includes top executives from Pfizer Inc., Aetna Inc. and the Mayo Clinic-are expected to approve a proposal that would call for raising Medicare’s eligibility age and shifting the program toward private plans for beneficiaries.  The group plans to press members of the congressional “supercommittee,” charged with finding $1.2 trillion in budget savings, to include the changes in its broader cost-cutting plan.

The council’s proposal is part of a larger effort inside the health industry to overhaul how lawmakers achieve savings from federal health programs. For years, Congress largely has relied on slicing payments to doctors and hospitals that treat Medicare beneficiaries to shrink spending in the program that insures 48 million elderly and disabled Americans.

Frustrated at being the target, the health industry is pushing back, arguing that some of those savings should come directly from the pockets of Medicare beneficiaries.

“This thinking that we’re protecting beneficiaries because we’re only cutting providers—that’s mythical,” said Mary Grealy, the council’s president. “At some point it does affect beneficiaries,” she said, because such cuts weaken health-care providers’ ability to offer services.

There’s growing pressure in Washington to rein in the major health-care entitlement programs—Medicare and Medicaid—as lawmakers struggle to cut the federal budget deficit.

Adamy, Janet,

Industry Seeks Savings from Medicare beneficiaries, The Wall Street Journal – Print and Online September 13, 2011

NAHU Capitol Hill Visits 2/15/2011

Attending Washington, DC as part of our annual Capitol Hill Conference visiting with our elected officials discussing the upcoming reform: health care exchange, what it means to our states, how will the states build their model to suit the residence and how do we fund and pay for the plan. We know MA Connector has been a huge negative impact with only a slight shift in enrollment and negative impact to small business owners.  What’s your state doing? 2014 is only a few years away.

Where’s Our Money Going?

According to the U.S. General accounting office, roughly 1 out of every 10 dollars is spent on public Healthcare programs is lost to fraud, waste and abuse. Fraud, Waste and Abuse account for the loss of billions of $$$ each year.

The Deadline for Medicare Drug Coverage Is Approaching.

Centers of Medicare and Medicaid Centers has extended the Special Election Period for those people who have lost their Medicare Advantage Plan or Preferred Drug Plan.  CMS will be sending a letter to all of those still eligible who have not made their SEP selection.

  • They will have until FEBRUARY 28, 2011 to choose a plan
  • Anyone who had a non-renewing plan and did not make a decision by 12/31/10 is currently on original Medicare
  • Anyone who has already enrolled in a MAPD or PDP will not be able to change plans
  • Anyone who has an SEP but doesn’t make their selection before February 28, 2011 will remain in original Medicare
  • A copy of the CMS letter must be sent with the application

The plan effective date for a February enrollment will be March 1, 2011. We are in the count down. Let me know if I can assist.

Congressional Face Off

Senate  slaps down the vote to repel the Health Care bill.  With only 300+pages of the bill written to reform healthcare have you read the other impacts? TAXES?  Hot topic, the much debated controversial mandate that will require most Americans to get health insurance starting in 2014.” The Times adds that “Republican leaders…have not indicated what part of the overhaul they will target first,” but “with funding for the federal government set to expire in four weeks, the next battleground could be legislation to keep the government operating from March to September.”

From KHN: Don’t Discount The Value of An Agent, They Discount Your Insurance

This excellent article by Janet Trautwein, CEO of National Association of Health Underwriters, explains why I do what I do and part of a great trade association helping fight our battles in Washington, DC.

Read the full article here:
http://www.kaiserhealthnews.org/Columns/2010/September/090910trautwein.aspx