Showing posts with label Medicaid. Show all posts
Showing posts with label Medicaid. Show all posts

A Family Member HomeCare, a Ft. Lauderdale, Broward Florida Home Health Care Agency Notes: Medicare prescription drug premiums to remain steady for third straight year


Average basic premiums for Medicare prescription drug plans are projected to remain constant in 2013, Health and Human Services Secretary (HHS) Kathleen Sebelius announced on August 6, 2012.  The average 2013 monthly premium for basic prescription drug coverage is expected to be $30. Average premiums for 2012 were projected to be $30 and ultimately averaged $29.67. At the same time, since the law was enacted, seniors and people with disabilities have saved $3.9 billion on prescription drugs as the Affordable Care Act began closing the “donut hole” coverage gap.
“Premiums are holding steady and, thanks to the health care law, millions of people with Medicare are saving an average of over $600 each year on their prescription drugs,” said Secretary Sebelius. 
Today’s projection for the average premium for 2013 is based on bids submitted by drug and health plans for basic coverage during the 2013 benefit year, and calculated by the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary. 
The upcoming annual enrollment period -- which begins Oct. 15 and ends Dec. 7, 2012 – allows people with Medicare, their families and their caregivers to choose their plans for next year by comparing their current coverage and quality ratings to other plan offerings. New benefit choices are effective Jan. 1, 2013.
Because of the Affordable Care Act, out-of-pocket savings on medications for people with Medicare continue to grow.  Last month, CMS announced that more than 5.2 million people with Medicare have saved over $3.9 billion on prescription drugs in the Medicare Part D donut hole since the law was enacted.  In the first half of 2012, over 1 million people with Medicare saved a total of $687 million on prescription drugs, averaging $629 per person this year.
As a result of the Affordable Care Act, coverage for both brand name and generic drugs in the coverage gap will continue to increase over time until 2020, when the coverage gap will be fully closed.  This year, people with Medicare received a 50 percent discount on covered brand name drugs and 14 percent coverage of generic drugs in the donut hole. In 2013, Medicare Part D’s coverage of brand name drugs will begin to increase, meaning that people with Medicare will receive a total of 52.5 percent off the cost of brand name drugs (a 50 percent discount and an additional 2.5 percent in coverage) and coverage for 21 percent of the cost of generic drugs in the donut hole.
For more information on how the Affordable Care Act closes the Medicare drug benefit donut hole, please visit:http://www.healthcare.gov/law/features/65-older/drug-discounts/index.html.

A FAMILY MEMBER HOMECARE — Approved by the Joint Commission on Accreditation of Healthcare Organizations. A Broward, Miami-Dade and Palm Beach County Home Health Care Agency Serving Coconut Creek, Cooper City, Coral Springs, Dania, Davie, Deerfield, Ft. Lauderdale, Hallandale, Hillsboro, Hollywood, Lauderdale Lakes, Lauderdale-by-the-Sea, Lauderhill, Lighthouse Point, Margate, Miramar, North Lauderdale, Oakland Park, Parkland, Pembroke Park, Pembroke Pines, Plantation, Pompano, Sea Ranch Lakes, Southwest Ranches, Sunrise, Tamarac, Weston, Wilton Manors, Aventura, Hialeah, North Miami, Miami Lakes, Sunny Isles, Bal Harbour, Surfside, Boynton, Boca Raton, Lake Worth & Delray Beach With Comprehensive Home Health Care Services, In-Home Caregivers, Nursing & Home Health Aides for Seniors, Elderly, Disabled, Dementia & Alzheimer’s Patients. Licensed, Bonded, Insured

A Family Member HomeCare, A Broward, Miami-Dade, Palm Beach Home Health Care Agency Supports the Affordable Care Act Implementation in Florida

Politifact Florida Notes that Florida Governor Rick Scott, in expressing his strong opposition to the Affordable Care Act, also got his facts wrong. He gave a one-sided and misleading account of how much the Medicaid expansion would cost the state, badly misrepresented requirements on small businesses and used a widely debunked talking point about "rationing."

What Florida COULD have . . . below:

The Affordable Care Act: Immediate Benefits for Florida

  • Small business tax credits.  290,000 small businesses in Florida could be helped by a new small business tax credit that makes it easier for businesses to provide coverage to their workers and makes premiums more affordable.1  Small businesses pay, on average, 18 percent more than large businesses for the same coverage, and health insurance premiums have gone up three times faster than wages in the past 10 years.  This tax credit is just the first step towards bringing those costs down and making coverage affordable for small businesses.
  • Closing the Medicare Part D donut hole. Last year, roughly 271,000 Medicare beneficiaries in Florida hit the donut hole, or gap in Medicare Part D drug coverage, and received no extra help to defray the cost of their prescription drugs.2 Medicare beneficiaries in Florida who hit the gap this year will automatically be mailed a one-time $250 rebate check. These checks will begin to be mailed to beneficiaries in mid-June and will be mailed monthly throughout the year as new beneficiaries hit the donut hole. The new law continues to provide additional discounts for seniors on Medicare in the years ahead and completely closes the donut hole by 2020. 
  • Support for health coverage for early retirees. An estimated 280,000 people from Florida retired before they were eligible for Medicare and have health coverage through their former employers. Unfortunately, the number of firms that provide health coverage to their retirees has decreased over time.3  Beginning June 1, 2010, a $5 billion temporary early retiree reinsurance program will help stabilize early retiree coverage and help ensure that firms continue to provide health coverage to their early retirees. Companies, unions, and state and local governments are eligible for these benefits.
  • New consumer protections in the insurance market beginning on or after September 23, 2010.
    • Insurance companies will no longer be able to place lifetime limits on the coverage they provide, ensuring that the 8.8 million Florida residents with private insurance coverage never have to worry about their coverage running out and facing catastrophic out-of-pocket costs.
    • Insurance companies will be banned from dropping people from coverage when they get sick, protecting the 1.1 million individuals who purchase insurance in the individual market from dishonest insurance practices.
    • Insurance companies will not be able to exclude children from coverage because of a pre-existing condition, giving parents across Florida peace of mind.
    • Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care.  This will protect the 7.7 million residents of Florida with health insurance from their employer, along with anyone who signs up with a new insurance plan in Florida.
    • Health insurers offering new plans will have to develop an appeals process to make it easy for enrollees to dispute the denial of a medical claim.
    • Patients’ choice of doctors will be protected by allowing plan members in new plans to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.
  • Extending coverage to young adults. Beginning on or after September 23, 2010, plans and issuers that offer coverage to children on their parents’ policy must allow children to remain on their parents’ policy until they turn 26, unless the adult child has another offer of job-based coverage in some cases. This provision will bring relief to roughly 86,300 individuals in Florida who could now have quality affordable coverage through their parents.4  Some employers and the vast majority of insurers have agreed to cover adult children immediately.
  • Affordable insurance for uninsured with pre-existing conditions. $351 million federal dollars are available to Florida starting July 1 to provide coverage for uninsured residents with pre-existing medical conditions through a new transitional high-risk pool program, funded entirely by the Federal government. The program is a bridge to 2014 when Americans will have access to affordable coverage options in the new health insurance exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. If states choose not to run the program, the Federal government will administer the program for those residents.
  • Strengthening community health centers. Beginning October 1, 2010, increased funding for Community Health Centers will help nearly double the number of patients seen by the centers over the next five years. The funding could not only help the 372 Community Health Centers in Florida but also support the construction of new centers.
  • More doctors where people need them. Beginning October 1, 2010, the Act will provide funding for the National Health Service Corps ($1.5 billion over five years) for scholarships and loan repayments for doctors, nurses and other health care providers who work in areas with a shortage of health professionals. This will help the 15% of Florida’s population who live in an underserved area.
  • New Medicaid options for states. For the first time, Florida has the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status. 

2 Office of the Actuary. Centers for Medicare and Medicaid Services. Number represents only non-LIS seniors.
3 Kaiser Family Foundation. 2009 Employer Health Benefits Survey.
4 U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2009; and 45 CFR Parts 144, 146, and 147.http://www.hhs.gov/ociio/regulations/pra_omnibus_final.pdf



A FAMILY MEMBER HOMECARE — Approved by the Joint Commission on Accreditation of Healthcare Organizations. A Broward, Miami-Dade and Palm Beach County Home Health Care Agency Serving Coconut Creek, Cooper City, Coral Springs, Dania, Davie, Deerfield, Ft. Lauderdale, Hallandale, Hillsboro, Hollywood, Lauderdale Lakes, Lauderdale-by-the-Sea, Lauderhill, Lighthouse Point, Margate, Miramar, North Lauderdale, Oakland Park, Parkland, Pembroke Park, Pembroke Pines, Plantation, Pompano, Sea Ranch Lakes, Southwest Ranches, Sunrise, Tamarac, Weston, Wilton Manors, Aventura, Hialeah, North Miami, Miami Lakes, Sunny Isles, Bal Harbour, Surfside, Boynton, Boca Raton, Lake Worth & Delray Beach With Comprehensive Home Health Care Services, In-Home Caregivers, Nursing & Home Health Aides for Seniors, Elderly, Disabled, Dementia & Alzheimer’s Patients. Licensed, Bonded, Insured
2525 North State Road 7, Suite 110 • Hollywood, FL 33021    |    8177 West Glades Road, Suite 221• Boca Raton, FL 33434
Phone: 954-986-5090 • Toll Free: 1-866-99-A-FAMILY (1-866-992-3264) • Fax: 954-986-5091

Florida Governor Rick Scott's Commission on Review of Taxpayer Funded Hospital Districts to Meet Tuesday, August 16, 2011; Access Meeting Materials Here

Florida Governor Rick Scott's Commission on Review of Taxpayer Funded Hospital Districts will meet again on Tuesday, August 16, 2011.  The Commission was created by Governor’s Executive Order Number 11-63 to assess and make recommendations on the role of hospital districts, whether it is in the public’s best interest to have government entities operating hospitals and what is the most effective model for enhancing health-care access for the poor.

To access complete meeting materials, including audio files, go to:  http://ahca.myflorida.com/mchq/FCTFH/fctfh.shtml

The official meeting notice is reprinted below.


FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION

THIS NOTICE IS AN ADDENDUM TO SECTION VI OF THE FLORIDA ADMINISTRATIVE WEEKLY, VOLUME 37, NUMBER 32, AUGUST 12, 2011 AGENCY FOR HEALTH CARE ADMINISTRATION

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Faye B. Miller, Bureau of Health Facility Regulation, Florida Center, Faye.Miller@ahca.myflorida.com or (850)412-3735, on or after August 9, 2011.

If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice). The Agency for Health Care Administration announces a public meeting to which all persons are invited. DATE AND TIME: Tuesday, August 16, 2011, 10:00 a.m. – 4:00 p.m. PLACE: Conference Room A, Building “3”, Florida Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, FL 32308. Any person interested in participating by telephone may dial: 1(888)808-6959, Participant Code: 8509223803. If you have any difficulty accessing the teleconference, please call the Florida Center’s Main Number at (850)412-3730.

GENERAL SUBJECT MATTER TO BE CONSIDERED: This is a meeting of the Commission on Review of Taxpayer Funded Hospital Districts. The commission was created by Governor’s Executive Order Number 11-63, to assess and make recommendations on the role of hospital districts, whether it is in the public’s best interest to have government entities operating hospitals and what is the most effective model for enhancing health-care access for the poor.

A copy of the agenda may be obtained by contacting: Faye Miller, Agency for Health Care Administration, 2727 Mahan Drive, Bldg. 3, Mail Stop #16, Tallahassee, FL 32308-5407. The agenda will also be posted at the Agency website: http://ahca.myflorida.com/mchq/FCTFH/fctfh.shtml. For more information, you may contact: Faye Miller, Bureau of Health Facility Regulation, Florida Center at Faye.Miller@ahca.myflorida.com or (850)412-3735.


For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach Home health care agencies home health care agency home health care services in home health care senior home health care home health care providers health care agency home health care jobs at home health care home health care agencies in florida home health care florida medicare home health care health care agencies home health care elderly home health agency home health care service home care agencies home health care companies home health care agency florida private home health care home health agencies elderly home health care home care agency what is home health care home health care agencies in broward county home health services home health care cost accessible home health care florida home health care home health aide agencies in home health care services home health care business home health aide home health care nursing home health care provider home health care employment in home health care jobs home health aide jobs home health aides home health care medicare in home health care agencies home health care seniors. We work with all South Florida hospitals and rehabilitation clinics to ensure safe transitions to in-home health care and provide attendants, caregivers, certified nursing assistants (CNA), companions, HHAs, homemakers. Providing homecare in Miami-Dade County, Broward County and Palm Beach County Member of Society of Certified Senior Advisors, National Association for HomeCare and Hospice; Home Care Association of Florida; American College of HealthCare Executives, Volunteer Broward, Hospice by the Sea, Rotary Club of Fort Lauderdale, Joseph Meyerhoff Senior Center, HomeHealthCompare, home health advance beneficiary notice, Florida Agency for Health Care Administration

The Florida Current Reports Florida Medical Association Opposes State's Medicaid Managed Care Overhaul

Florida Senator Nan Rich initiated the objection to Florida's misguided managed care overhaul.  The Florida Current reports on the latest development:







Powerful doctors group opposes Medicaid managed care overhaul


Christine Jordan Sexton, 8/4/2011
www.thefloridacurrent.com 


A powerful new foe has come out against Florida's push to overhaul the state's $22 billion Medicaid program.


The Florida Medical Association is now the latest group to join a long list of those opposed to the sweeping reform of the safety-net program for the poor, elderly and disabled passed by the GOP-controlled Legislature and signed into law by Gov. Rick Scott.


The move is significant because Republicans have worked in tandem with the FMA on several initiatives in recent years, including a medical malpractice bill during the 2011 session.


Under a resolution approved by the FMA House of Delegates last weekend, the state’s largest doctor’s organization will be required to send a letter to the federal government within one month specifically asking the Centers for Medicare and Medicaid Services not to extend an existing waiver that allows a Medicaid Reform pilot in five counties to expand statewide and, furthermore, not to approve any new waiver needed to remodel Medicaid "because Florida has failed and is still failing to properly address concerns by patients, physicians, hospitals" and the federal government.


The resolution was championed by the Broward County Medical Association and its president, Aaron Elkin, an OB/GYN and a Medicaid participating provider who has first hand experience with the Medicaid Reform pilot project since its inception in 2005. Elkin said under Medicaid Reform he rarely sees pregnant patients in their first trimester and often does not see them until midway of their second semester.


"It's a huge thing for the FMA to send a letter to CMS and to say 'stop,'" Elkin said in an interview. "We're going to put our foot down."


The FMA resolution also maintains that there is "no clear and convincing evidence" that the five-year old Medicaid reform pilot program in place in Broward and four Northeast Florida counties has saved money or ensured access to quality care.


Florida Medical Association President Miguel Machado was traveling and unavailable for comment.


Elkin said the FMA always opposed reform initiatives that would place more patients into managed care, but that the organization had different priorities during the recent legislative session.


The FMA’s priority bill for the 2011 session was a medical malpractice related measure HB 479 -- which requires out of state physicians to obtain an expert witness certificate before they can testify in medical malpractice cases.


“It’s not enough to oppose an issue,”said Elkin. “This is the first time an organization that is so close to the Legislature is standing publicly against (Medicaid reform).”


There already have been a series of letters sent to CMS asking the federal government to reject Florida’s waiver for the existing Medicaid Reform pilot project and the new overhaul of the Medicaid program that would require everyone to be enrolled in managed care, including those requiring nursing home care.


Senate Democratic Leader Nan Rich, D-Weston sent a two page letter to the federal government in June. That was followed by a letter sent July 14 from four House Democrats -- Reps. Mia Jones, Steve Perman, Elaine Schwartz and Mark Pafford -- who also called on the feds to reject the plan.


Those letters were followed up by a letter from the health care advocacy group Florida CHAIN, whose letter was signed by more than 100 organizations -- including the Broward, Miami-Dade and Hillsborough county medical associations.


"It's America, everyone is entitled to their opinion," said Sen. Don Gaetz, R-Niceville and incoming Senate president. Gaetz was one of a number of Republicans in the Senate who negotiated the Medicaid Reform overhaul with the House of Representatives.


Gaetz said that the FMA never made any promise to him to support the plan to overhaul Medicaid. But he said he asked the FMA -- as well as Senate Democrats -- for input to help improve the proposal so the Senate "could make the legislation as good as it could be."


"I guess if Leader Rich can do it so can the FMA," said Gaetz.


Elkin has had experience with the Medicaid Reform pilot since 2005 when it launched in Broward County and he said the program has been a mess since its inception. "Managed care companies don’t coordinate care," he said, "they manage claims."




For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach Home health care agencies home health care agency home health care services in home health care senior home health care home health care providers health care agency home health care jobs at home health care home health care agencies in florida home health care florida medicare home health care health care agencies home health care elderly home health agency home health care service home care agencies home health care companies home health care agency florida private home health care home health agencies elderly home health care home care agency what is home health care home health care agencies in broward county home health services home health care cost accessible home health care florida home health care home health aide agencies in home health care services home health care business home health aide home health care nursing home health care provider home health care employment in home health care jobs home health aide jobs home health aides home health care medicare in home health care agencies home health care seniors. We work with all South Florida hospitals and rehabilitation clinics to ensure safe transitions to in-home health care and provide attendants, caregivers, certified nursing assistants (CNA), companions, HHAs, homemakers. Providing homecare in Miami-Dade County, Broward County and Palm Beach County Member of Society of Certified Senior Advisors, National Association for HomeCare and Hospice; Home Care Association of Florida; American College of HealthCare Executives, Volunteer Broward, Hospice by the Sea, Rotary Club of Fort Lauderdale, Joseph Meyerhoff Senior Center, HomeHealthCompare, home health advance beneficiary notice, Florida Agency for Health Care Administration