BY EILEEN KIRKLIN: Jim Betts of Winthrop, Maine, did all the right things to prepare for a simple but comfortable retirement. The former claims adjudicator worked hard, saved money and lived within his means. However, the 66-year-old may spend the remainder of his golden years living in poverty. Why?
He needs to breathe.
Betts, who suffers from severe asthma, is one of millions of older Americans who are at risk of losing access to vital health coverage if Republican leaders in Congress have their way. (read more)
BY JAMES SWANN: Medicare contractors have many jobs, ranging from processing standard Medicare claims to recovering improper payments, and they generally perform them well. However one job, reconciling outlier payments, is tripping them up, according to a recent Health and Human Services Office of Inspector General report. The OIG said contractor mistakes with outlier payments may have cost the program $426 million between 2003 and 2011.
The report identified 465 hospital cost reports that should have been referred for outlier reconciliation or were referred but never reconciled. Failing to reconcile outlier payments before reaching a final settlement on a hospital’s cost report can lead to Medicare overpayments. (read more)
BY MARGOT CLEVELAND: Republicans acknowledged yesterday that their second attempt to repeal and replace the Affordable Care Act has failed. This news comes as those seeking coverage on the Obamacare exchanges prepare for the upcoming open-enrollment period, set to run from November 1 to December 15. There, insurance shoppers will face another year of steep increases: from a 16 percent increase in Michigan, to as much as a 76 percent increase in Oklahoma.
In light of these developments, Sen. Bernie Sanders’s evergreen proposals—“Medicare For All,” and lowering the cost of prescription drug prices by requiring “Medicare to use its bargaining power to negotiate with the prescription drug companies for better prices”—will likely hit front pages and television screens again soon. (read more)
Medicare doesn’t cover everything. Luckily, those on Medicare can now start saving on out of pocket expenses like prescription drugs, dental, vision, hearing, and more. Over 1 million people have already received their free Medicare Plus Card.(Read More...)