Today’s Hot Topics in Medicare News

Will Medicare Part B cost more with 401(k) withdrawal?

BY KARIN PRICE MUELLER: Q. I took a large withdrawal from my 401(k) to put a down payment on another home in Florida. I withdrew $72,000 with 20 percent withheld to go for taxes. My adjusted gross income is about $130,000 this year. Am I going to have to pay more on Medicare B? I’m married with no other dependents.

— Retiree

A. You’re right to wonder about the costs.

Your income has everything to do with what you’ll pay for Medicare.

Medicare Part B criteria for 2019 states, “The standard Part B premium amount in 2019 will be $135.50.” (read more)

Medicare, Medicaid Exclude 200% More Docs for Healthcare Fraud

BY JACQUELINE LAPOINTE: Efforts to combat healthcare fraud, waste, abuse by Medicare, Medicaid, and public insurance programs may be paying off, according to a new study from the University of Southern California and Harvard Medical School.

The study recently published in JAMA Network Open revealed that the number of physicians excluded from Medicare, Medicaid, and other public healthcare programs increased by about 200 percent from 2007 to 2017. The physicians had to exit the programs because of healthcare fraud schemes, health crimes, or unlawful prescribing of controlled substances.

The trio of researchers also found that excluded physicians during the ten-year period were more likely to be male, older, not have a faculty appointment at a US medical school, and have graduated from osteopathic medical school or were an international medical graduate. (read more)

CBO: Here’s what Medicare, Medicaid cuts would do to the national deficit

BY EMILY RAPPLEYE: A periodical report from the Congressional Budget Office offering Congress ideas on how to reduce the federal deficit includes several options to reduce spending via cuts to Medicare and Medicaid.

The options in the report, which are neither opposed nor endorsed by the CBO, outline various possibilities and their effects on the federal deficit. Here are a few of the options that would affect Medicare and Medicaid: 

1. Cap federal Medicaid spending. Depending on how these caps are designed, they could save anywhere from $162 billion to $703 billion from 2019-28, the CBO estimates. The CBO measured the effect of overall spending caps or per-enrollee caps. Capping federal Medicaid spending would make spending on the currently open-ended program more predictable, but it would also likely shift costs onto states, the report notes. (read more)

Provider Directory Accuracy Issues Persist for Medicare Advantage

BY JACQUELINE LAPOINTE: Online Medicare Advantage provider directories are still not accurate, according to a recent CMS analysis of approximately one-third of Medicare Advantage Organizations (MAOs).

In its third round of online provider directory reviews, CMS analyzed the accuracy of online provider directories of 52 MAOs, which represented over 5,600 providers at 10,500 locations.

The federal agency found that almost 49 percent of the provider directory locations had at least one inaccuracy. The inaccuracies included provider not practicing or accepting the plan at the location listed, incorrect phone number, or the provider was not accepting new patients when the directory indicated they were. (read more)

Medicare drug proposal will prevent new medicines from coming to market

BY TOMMY G. THOMPSON: Woven within the fabric of our country is the core understanding that leadership comes with both great opportunity and cost. We have long led the world in pharmaceutical innovation, a distinction we’ve proudly maintained as mergers and acquisitions have reshaped the highly competitive industry. Studies estimate that nearly two-thirds of all new pharmaceuticals originate in the United States, a percentage that has grown over the past thirty years, fueling a booming biotech industry that provides front-line products combating our most vicious diseases.

A new threat has emerged to our country’s position as the global leader in pharma innovation and it comes from within our borders. The administration’s new proposal to tie Medicare reimbursement to the price control rates paid by European single-payer states will undoubtedly harm competition and reduce the number of new medicines coming to market. As a former secretary of the Department of Health and Human Services (HHS), I want to suggest another way to get to the same result rather than foreign price controls as a reference price for Medicare drugs. (read more)

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