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Josh Vandenberg

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Summary of Medicare Provisions in Budget for Fiscal Year 2015

Posted by Josh Vandenberg on Fri, Mar 14, 2014 @ 03:29 PM

Medicare Supplements This is a brief summary of the Medicare provisions included in the federal budget proposal for FY2015: if adopted, it would reduce Medicare spending by more than $400 billion between 2015 and 2024, accounting for about 25 percent of all reductions in federal spending included in the budget. More than one-third (34%) of the proposed Medicare savings are due to reductions in payments for prescription drugs under Medicare Part B and Part D. (UPDATED YESTERDAY). One-third (33%) of the proposed Medicare savings are due to reductions in Medicare payments to providers. About 16 percent of the proposed Medicare savings are due to increases in beneficiary premiums, deductibles and cost-sharing.

Figure 1: Distribution of Medicare Savings in President Obama’s FY2015 Budget

Figure 1: Distribution of Medicare Savings in President Obama’s FY2015 Budget

Summary of Medicare Provisions in the President’s Budget

Beneficiary Premiums, Deductibles And Cost-Sharing

  • Income-Related Part B And Part D Premiums
  • Part B Deductible
  • Home Health Copayment
  • Surcharge On Medigap Coverage
  • Part D Copayments

Dual-Eligible Beneficiaries

  • Program for All-Inclusive Care for the Elderly (PACE) Program
  • Appeals Process
  • Qualified Individuals

Other topics discussed in more detail include:

Medicare Advantage, Prescription Drugs, Physician Payments and the Sustainable Growth Rate (SGR) Formula & Medicare Payments to Other Providers

To review the full story please follow this link: http://kff.org/medicare/issue-brief/summary-of-medicare-provisions-in-the-presidents-budget-for-fiscal-year-2015

Source: Kaiser Family Foundation

Additional Updates:


Tags: Medicare Advantage, Medicare, President Obama

Obama's Not-So-Secret War On Private Medicare Plans

Posted by Josh Vandenberg on Tue, Mar 04, 2014 @ 11:36 AM

Medicare Supplements To say that President Obama is not an enthusiastic backer of the two Medicare programs that offer seniors private insurance options would be something of an understatement.

Over the years, Obama has repeatedly derided Medicare Advantage — the program that lets seniors enroll in subsidized, private insurance. He once called it "wasteful," and said it amounted to "giveaways that boost insurance company profits but don't make (seniors) any healthier."

Obama has been equally harsh when it comes to Medicare Part D — the drug benefit President Bush signed into law that relies on privately run plans.

In his 2006 book, "The Audacity of Hope," Obama blasted the program, saying it "somehow managed to combine the worst aspects of the public and private sectors." As president, he said it gave overly generous "taxpayer subsidies to prescription drug companies."

Both programs, it turns out, have been wildly popular with seniors and, by most measures, big successes. But Obama nevertheless appears determined to undermine them with sharp cuts in payments and sweeping new regulations.

Started back in 1997 — and initially called Medicare+Choice — the Medicare Advantage program pays private insurers a set amount per enrollee to provide comprehensive benefits and anything else they can afford to offer.

The idea was that private insurers could better co-ordinate care and manage health costs than the old fee-for-service Medicare, and so provide more comprehensive benefits.

While enrollment in these private plans was flat for the first several years, it has skyrocketed since 2005, to the point where almost one in three seniors are covered by a private health plan. And, contrary to Obama's claim, these seniors tend to get better quality health care than those in traditional Medicare.

Critics, however, point to studies showing that the government pays Medicare Advantage more per enrollee than it would cost if these seniors had enrolled in the old Medicare program.

Obama tried to remedy this by cutting payments by a total $200 billion over the next decade to help pay for ObamaCare (while providing "bonus" payments to plans that score high on a quality rating). An official analysis from Medicare's actuary concluded, however, that such cuts would drive millions seniors out of their Advantage plans and back into the government-run program.

Recognizing political risks of these payment cuts, the administration put them off until after the presidential elections, shoveling $8 billion into a bogus "demonstration project" that offset almost all the scheduled Medicare Advantage cuts in 2012.

Question: What are your thoughts about President Obama's cuts to the Medicare Advantage Program?

Source: Investor's Business Daily
Additional Updates:

  • Combined Insurance Company - Hot new Plan "G" Release
    Approved: Illinois, Kentucky, Pennsylvania & Tennessee
    Filed: Alabama, Indiana, Mississippi, South Carolina & Texas

Tags: Medicare Advantage Cuts, Part D, President Obama

Senators Concerned About Medicare Advantage Cuts

Posted by Josh Vandenberg on Thu, Feb 20, 2014 @ 11:00 AM

Medicare Supplements Some Democrats have now joined their Republican counterparts in asking the Obama administration to moderate scheduled Medicare Advantage payment cuts for 2015.

In a letter to Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner, a bipartisan coalition of 40 senators urged the administration “to maintain payment levels that will allow [Medicare Advantage] beneficiaries to be protected from disruptive changes in 2015.” Cuts to Medicare Advantage plans are part of the $716 billion in Medicare spending reductions the health law calls for over the next decade.

Senate Democrats who signed the letter include Charles Schumer of New York, a member of the Senate Democratic leadership team, as well as several who are facing tough re-election campaigns, including Kay Hagan of North Carolina, Mark Pryor of Arkansas and Mary Landrieu of Louisiana.

As early as this week, CMS is expected to release preliminary Medicare Advantage payment rates for 2015 that insurers have estimated could reduce payments by as much as 6 percent to 7 percent next year. Insurers and other Medicare Advantage proponents say cuts of that magnitude could cause premium increases and benefit reductions.

“Seniors cannot afford another round of rate cuts to their Medicare Advantage coverage,” said AHIP President and CEO Karen Ignagni in a release. “CMS should protect seniors in the program by maintaining current payment levels next year.” Final Medicare Advantage payment rates for 2015 are scheduled to be released in April.

According to the senators’ letter, about 15 million seniors and individuals with disabilities — accounting for 28 percent of Medicare beneficiaries — are enrolled in Medicare Advantage plans. The policies tend to offer extra benefits, such as hearing aids or gym memberships, that are not available in traditional Medicare.

For years, Medicare Advantage plans were paid more per beneficiary than what Medicare paid for beneficiaries enrolled in traditional fee-for-service. The health law aims to equalize that spending over time, so the government pays the same amount whether a beneficiary enrolls in Medicare Advantage or traditional Medicare.

The Senate letter isn’t the first of its kind from lawmakers. In a Feb. 13 letter to President Barack Obama, House GOP leaders and key Republican committee chairs expressed their concern over the impending Medicare Advantage cuts. The cuts, along with additional CMS regulations, “will force millions of Americans to face higher health care costs or lose access to their doctor, health plan, lifesaving drugs, and the benefits they’ve come to rely on.”

However, federal officials’ choices may be limited. In a blog post, Edwin Park of the Center on Budget and Policy Priorities, a left-leaning think tank, writes that the insurers’ campaign against the payment cuts suggests that the administration will make trims beyond those included in the health law. “In reality, as was the case last year, the [a]dministration likely won’t propose any new payment reductions,” Park wrote. “It will likely just announce how it will apply existing law, reflecting the combined impact on Medicare Advantage payment rates of health reform and the continued slowdown in growth in Medicare Costs.”

Source: Kaiser Health News


Additional Updates:

Tags: Spending Cuts, 2015, Medicare Advantage

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