News
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Usmexico Social Security Treaty Must Be Opposed
The Senate Finance Committee recently passed The Prescription Drug Pricing Reduction Act out of committee and now it heads to the floor for further action. The bill, which has support of both Democrats and Republicans would, among other things, cap drug prices based on the rate of inflation. .The new cards will have unique, randomly-assigned numbers called a Medicare Beneficiary. Benefit Bulletin: June 2016 Can You Identify Medicare Fraud In This Story? .In response to heightened concerns over antibiotic resistance, two dozen of the world's largest pharmaceutical companies have formally launched a billion for-profit venture fund to replenish the global medicine chest with novel treatments. … Continued
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Issues Medicare Means Testing Faqs Feed
For more information about legislation that would strengthen the Social Security and Medicare programs, visit the Bill Tracking section of our website. For frequent updates from TSCL on Capitol Hill and to view photos from this week, follow us on Twitter. .In a statement issued early this week, America's Health Insurance Plans, an advocacy organization for insurers, wrote: "Reports from leading industry analysts show broad consensus that the CMS proposal, if finalized, would result in Medicare Advantage payment cuts of at least 4 percent in 2015 and likely much higher once other changes are factored in." But in a statement of their own, representatives from CMS countered: "The proposed changes for 2015 for Medicare Advantage are smaller than those implemented in 2014 – a year in which CMS expects to exceed its 5 percent enrollment growth projection." They went on to claim that the 2015 MA cut will actually result in lower premiums and better care for seniors. .Lawmakers Adjourn for Recess … Continued
Last fall, the Government Accountability Office uncovered .3 billion in improper payments from December 2010 to January 2013 made to people who had jobs when they were supposed to be unable to work. To be eligible for Social Security disability, beneficiaries must be unable to work due to a medical condition that's expected to last at least one year, or result in death. The list, however, includes murky afflictions like back pain, depression and other un-measurable afflictions, opening the system to fraud and abuse. .The cost of additional coverage varies significantly. There are pros and cons that need to be weighed for the type of selection you make for your additional coverage. For example, you should ensure that your Part D or Medicare Advantage plan is selected based on the drugs you take, and the doctors and hospitals you actually use. (A Medicare benefits counselor will check this information for you on the Medicare website.) While the cost of this additional coverage varies, the coverage offered may be identical, and that is why we recommend getting help from a SHIP counselor, who can help you find coverage to keep your costs to a minimum. Medigap insurance, for example, costs more for the premium, but you would have minimal out-of-pocket costs. On the other hand, you might pay less for the premium of a Medicare Advantage plan, and perhaps get some additional benefits like vision care, but you would have co-pays or co-insurance for each service. In Central Virginia, for example, a Medigap G policy may be found for about 0 per month, and roughly per month for the drug plan (or even less). .Even though I have good insurance, I wound up with ,260 in unexpected out-of-pocket costs after being referred to a specialist who ordered "a few tests." I later learned that most, if not all of the tests I was given were probably unnecessary, and not recommended by the physician groups, based on my medical history. The visit with my specialist lasted only 15 minutes. At check out I learned the doctor had ordered four high-tech tests including a CT scan. No explanation was given about what the doctor was looking for, why the tests were necessary, or how they would help, nor was I given the opportunity to go back and ask the doctor before leaving. Nothing abnormal was found in any one of them. While I'm grateful for that, the stack of bills I received later forced me to tap savings that I was hoping to count on for retirement. .Oxford's study, however, found that the vaccine not only prevented severe disease but appeared to cut transmission of the virus by two-thirds. The study has not been peer-reviewed yet. .In January, lawmakers on Capitol Hill will likely begin efforts to repeal the Affordable Care Act, overhaul the tax code, dramatically alter trade deals, and confirm a new Supreme Court Justice. It remains to be seen which other policy issues will be prioritized by the Republican Congress. Efforts to reform the Social Security and Medicare programs have been on the table for years, and in the platform that the Republican party adopted back in July, lawmakers agreed that "of the many reforms being proposed, all options should be considered." Proposals to raise the Medicare eligibility age or to adopt the "chained" CPI – which would result in more slowly-growing Social Security cost-of-living adjustments – could see congressional action in 2017. .The fall recess continued this week, and Members of the House and Senate remained in their home states and districts to prepare for the upcoming elections, which will occur on Tuesday, November 4th. They are expected to return to Washington following the elections for a "lame duck" session. .The Covid-19 pandemic has both heightened the urgency of reining in pharmaceutical costs yet also made it harder for lawmakers to act. Drug makers say limiting their profits could hamper efforts to create a vaccine against the virus, but medicines to treat it come with significant price tags. Gilead Sciences, Inc., set the price for its widely used Remdesivir at ,340 for a five-day treatment. ."The vast majority of prescription drugs [in the U.S.] are for generic, and there, the U.S. does pretty well," says Andrew Mulcahy, PhD, a senior policy researcher at RAND and the lead author of the report. "But for brand-name drugs, we pay much higher." .Consequently, Medicare spent billion in 2013 but paid out billion by 2017 for these treatments. In addition, neurology medicines, mostly those used to combat multiple sclerosis, accounted for more than 50% of total Medicare payments, despite representing just 4% of all claims filed.