Nope -- doesn't bother me at all. I didn't mean to word it that way.
My intent was to point out what I did because, like I said, most of them are
filled with bureaucracy or "baffle them with bullsh*t" things where you have
to read between the lines. It is still that but this one stuck out to me
more so I wanted to comment.
Lori :-)
On Wed, Oct 15, 2008 at 5:27 PM, <[EMAIL PROTECTED]> wrote:
> I am sending just in case everyone is not subscribed to this. Sorry my
> sending it bothers you, Lori.
>
> Dana
>
> In a message dated 10/15/2008 6:14:46 P.M. Central Daylight Time,
> [EMAIL PROTECTED] writes:
>
> I am subscribed to the biweekly electronic newsletter MEDICARE WATCH and
> so should most people rather than getting it from here. It is usually just
> a bunch of bureaucracy but this one caught my eye.
>
> *Notice #3 below* regarding nursing homes. 91% is a huge number and might
> as well be 100%. Further, notice that the nursing homes were only "cited"
> for Deficient Care rather than having anything done about it other than a
> slap on the wrist.
>
> Then, look at #4 where the topic is --* MEDICARE STOPS PAYING HOSPITALS
> FOR MEDICAL ERRORS. *
>
> *It SHOULD READ or SAY* "Medicare Stops Paying Hospitals for Medical
> Errors *AND* Hospitals Will Not Be Allowed to go after the patient for ANY
> balances."
> If ALL that occurred (to protect the patient) -- hospitals would probably
> not want to take Medicare patients. But since it is federal I don't think
> they would be allowed to do that.
>
> In any case, what I added above Re: #4 -- it should be recognized and
> included in the Medicare policy. But apparently it is not.
>
> Sometimes it is so laughable to read "A Patient's Bill of Rights." I know
> they hang on the walls of assisted living facilities and probably on nursing
> home walls as well but as you can see above -- that is a joke.
>
> Lori
>
> On Tue, Oct 14, 2008 at 10:59 PM, <[EMAIL PROTECTED]> wrote:
>
>> Welcome to MEDICARE WATCH, a biweekly electronic newsletter of the
>> Medicare Rights Center
>>
>> Vol. 11 , No. 21 : October 14, 2008
>>
>>
>> Contents:
>>
>> *1. FAST FACT* **
>>
>> *2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS
>> RISE *
>>
>> *3. NURSING HOMES WIDELY CITED FOR DEFICIENT CARE*
>>
>> *4. MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS*
>>
>> *5. CASE FLASH: SWITCHING PRESCRIPTION COVERAGE FROM A MEDIGAP PLAN TO
>> PART D *
>> ------------------------------
>>
>> *1. FAST FACT*
>>
>> According to Douglas Holtz-Eakin, Senator John McCain's senior policy
>> adviser, the health care reform plan offered by Sen. McCain will have major
>> cuts for Medicare and Medicaid. The nonpartisan Tax Policy Center, a
>> Washington think tank, estimates that the McCain plan would cost the
>> government $1.3 trillion over 10 years. The McCain campaign has not disputed
>> these figures or offered their own. ("McCain Plans Federal Health Cuts",
>> *Washington Post*, October 2008)
>> <http://www.kintera.org/TR.asp?a=glKSK6PQJfIYLrK&s=fqLHJWMCIbLHI0NPG&m=kkJWLaOPLfJ3F&af=y>
>>
>>
>>
>> *2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS
>> RISE*
>>
>> At least 1.3 million low-income people with Medicare will be reassigned to
>> a new prescription drug plan in 2009, as the number of drug plans that
>> qualify for a full premium subsidy dropped from 495 in 2008 to 308 in 2009,
>> according to Avalere, a health consultancy firm.
>>
>> Low-income people who qualify for full Extra Help can receive premium-free
>> drug coverage, but only in a plan that charges a premium below the regional
>> average. When a drug plan's premium rises above that average, which is reset
>> every year, the Centers for Medicare & Medicaid Services reassigns most
>> Extra Help recipients in that plan to a new drug plan with a premium below
>> the average. Because reassignment is random, and plans vary greatly in the
>> drugs they cover and the coverage restrictions they impose, low-income
>> people will face new coverage restrictions under their new plan.
>>
>> In all but one state, Wisconsin, the number of drug plan offerings for
>> low-income Medicare enrollees decreased. In six states – Arizona, Florida,
>> Hawaii, Maine, Nevada and New Hampshire – there will be five or fewer
>> drug plans available to automatically enroll low-income people with Medicare
>> in 2009. Nevada will have only one drug plan for those people automatically
>> reassigned by CMS, eliminating any choice of stand-alone drug plans for
>> low-income enrollees unless individuals can pay for part of the premium cost
>> from their limited incomes. Arizona has the second fewest options for
>> low-income enrollees, with only two zero-premium drug plans for Extra Help
>> recipients.
>>
>> Humana completely withdrew from the low-income market, offering no plans
>> with premiums below the benchmark. However, United Healthcare increased the
>> number of PDPs it will offer to low-income people with Medicare after it
>> lost nearly 600,000 low-income enrollees last year.
>>
>> The number of people reassigned by CMS has increased annually since Part D
>> went into effect in 2006. In 2007 CMS reassigned 250,000 people; the number
>> steeply jumped in 2008, when CMS reassigned 1.2 million people.
>>
>>
>> *3. NURSING HOMES WIDELY CITED FOR DEFICIENT CARE*
>>
>> From 2005 to 2007 more than 91 percent of nursing homes surveyed were
>> cited for deficiencies, the Health and Human Services Department Office of
>> Inspector General (OIG) reports. Nearly 17 percent of nursing homes had
>> deficiencies that caused residents actual harm or immediate jeopardy of
>> harm, with a greater percentage of for-profit nursing homes cited for these
>> serious violations than not-for-profit nursing homes.
>>
>> The most common deficiency categories cited in each of the past three
>> years were quality-of-care, resident assessment and quality of life. Almost
>> 74 percent of nursing homes surveyed were cited for deficiencies involving
>> accident hazards, and failure to prove the highest physical, mental and
>> psychosocial care for the residents' well-being. Around 34 percent of
>> nursing homes were cited for improper storage, preparation or serving of
>> food.
>>
>> In addition, 17 percent of nursing homes surveyed in 2007 were cited for
>> actual harm or immediate jeopardy deficiencies. Examples of these problems
>> included infected bedsores, medication mix-ups, poor nutrition and abuse and
>> neglect of residents.
>>
>> *4. MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS*
>>
>> The Centers for Medicare & Medicaid Services (CMS) will no longer
>> reimburse hospitals for ten categories of preventable medical errors that
>> result in serious risk of injury to patients. CMS prohibits hospitals to
>> charge people with Medicare for the additional costs associated with
>> treating these conditions.
>>
>> Hospitals will now assume the costs of procedures associated with "never
>> events," so called because they should never occur. While Medicare will save
>> $21 million as a result of the new policy, the primary purpose of the rule
>> is to improve quality of care for people with Medicare by creating greater
>> incentives for doctors and hospitals to avoid preventable errors. The
>> expectation is that if these errors affect hospitals' overall budgets,
>> doctors and hospitals will take more aggressive measures to prevent these
>> errors.
>>
>> The ten categories of "never events" Medicare no longer covers include
>> remedial treatments related to foreign objects retained by patients after
>> surgery; transfusion of incompatible blood; falls and traumas during a
>> hospital stay; manifestations of poor glycemic controls; catheter-associated
>> urinary tract infections; surgical site infection following a coronary
>> artery bypass graft or orthopedic surgery; and deep vein
>> thrombosis/pulmonary embolism.
>>
>> *
>> **5. CASE FLASH: SWITCHING PRESCRIPTION COVERAGE FROM A MEDIGAP PLAN TO
>> PART D *
>>
>> Mr. S has had Original Medicare Parts A and B since 2005. He has also had
>> a Medicare supplemental plan with drug coverage, Medigap Plan H. Medigap
>> Plan H (along with Plans I and J) with drug coverage has not been sold since
>> January 1, 2006, when the Medicare drug benefit (Part D) began. However,
>> people like Mr. S, who bought one of these Medigap plans with prescription
>> drug coverage before that time, can keep the Medigap's drug coverage.
>>
>> In the past year, Mr. S's overall health has declined. As a result, his
>> prescription drug costs have gone up, but Mr. S's Medigap plan only pays up
>> to a certain amount each year for his drugs, leaving him paying a high price
>> out-of-pocket for the medications he needs. Mr. S began looking for other
>> options to get more comprehensive coverage for his prescription needs. He
>> decided that he would prefer to enroll in a Medicare Part D plan for his
>> prescription drug coverage.
>>
>> In August Mr. S called the Medicare Rights Center for help choosing a
>> Medicare
>> Part D plan. The Medicare Rights Center hotline counselor told Mr. S that
>> he would have to wait until the Annual Coordinated Election Period (ACEP) to
>> switch plans; the ACEP runs from November 15th to December 31st. For
>> people who sign up for a Part D plan during the ACEP, Part D coverage
>> becomes effective on January 1st.
>>
>> The hotline counselor went on to warn Mr. S that he would likely have to
>> pay a Part D premium penalty when he enrolled in a drug plan because Medigap
>> Plan H drug coverage is not considered "creditable coverage"—coverage that
>> is as good as or better than the Medicare drug benefit. In most cases,
>> people with Medicare who do not enroll in Part D when they are first
>> eligible and do not have creditable coverage have to pay a premium penalty
>> for enrolling late. People who qualify for Extra Help—a federal program that
>> helps pay for Part D costs—can avoid this penalty regardless of when they
>> enroll. Since Mr. S had income too high to qualify for Extra Help, he would
>> have to pay a premium penalty in addition to his monthly premium for as long
>> as he remained enrolled in Medicare Part D. Since Mr. S could have enrolled
>> in a Medicare drug plan in the spring of 2006 when the first Part D
>> enrollment period ended, he would have to pay a premium penalty that would
>> be calculated based on the number of months that he delayed enrollment in
>> Part D.
>>
>> Mr. S decided that even with the premium penalty, it would be a better
>> idea for him to choose a prescription drug plan that provided him better
>> coverage than to stick with his Medigap plan with prescription drug
>> coverage. The longer Mr. S waited to enroll in Part D, the greater his
>> premium penalty would be. Together, Mr. S and the hotline counselor used the
>> Prescription Drug Plan Finder on Medicare.gov and searched for different
>> Part D plans that covered Mr. S's medications without restrictions at the
>> lowest cost.
>>
>> The hotline counselor also mentioned that Mr. S has the option of
>> enrolling in a Medicare private health plan with prescription drug coverage,
>> but Mr. S told the hotline counselor that he wanted to stay in Original
>> Medicare because he would be able to continue to see the same doctors. If
>> Mr. S wanted to keep the health benefits of his Medigap Plan H, Mr. S could
>> enroll in a Part D plan and then call his Medigap plan to request that they
>> drop him from the prescription drug component of the plan and adjust his
>> monthly Medigap premium so that he is no longer paying a prescription drug
>> premium to his Medigap plan.
>>
>> ------------------------------
>>
>> This message was generated by the Medicare Rights Center list-serve.
>>
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>> Telephone: 212-869-3850
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>>
>> Web site:
>> www.medicarerights.org<http://www.kintera.org/TR.asp?a=bgKILRNwFbKJK6L&s=fqLHJWMCIbLHI0NPG&m=kkJWLaOPLfJ3F&af=y>
>>
>> Get a jump start on holiday shopping on the *Medicare** **Rights** **
>> Center** Celebration 2008 Silent Auction website.* From fantasy trips to
>> fun items, you'll find one of a kind items galore to bid on as gifts – for
>> others or for yourself! Go to
>> www.medicarerights.org/events/auction.html<http://www.kintera.org/TR.asp?a=etLOL0OIIeIQIgK&s=fqLHJWMCIbLHI0NPG&m=kkJWLaOPLfJ3F&af=y>to
>> begin bidding on these unique items, such as a house in
>> Ireland for a week, tickets to a Metropolitan Opera Dress Rehearsal, and
>> autographed sports memorabilia.
>>
>> ------------------------------
>>
>>
>> *Medicare Watch* is the Medicare Rights Center's fortnightly newsletter,
>> established to strengthen communication with national and community-based
>> organizations and professional agencies about current Medicare policy and
>> consumer issues. Each edition contains news of recent policy developments
>> affecting Medicare and health care generally and a case story from our
>> hotline that illustrates steps professionals can take to get older adults
>> and people with disabilities the health care they need.
>>
>> The Medicare Rights Center is a national, not-for-profit consumer service
>> organization that works to ensure access to affordable health care for older
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>
>
> --
> Lori
> C4/5 complete quad, 27 years post
> Tucson, AZ
>
>
>
>
>
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--
Lori
C4/5 complete quad, 27 years post
Tucson, AZ
