CMS Issues User Guide Version 3.3

The Centers for Medicare and Medicaid Services (“CMS”) posted Version 3.3 of the User Guide, dated December 16, 2011 (the “Version 3.3”) on its website. Version 3.3 includes the guidance that CMS has provided in various alerts since the previous User Guide was published as of August 1
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Medicare passes on big profits to insurers

NEW YORK (CNNMoney) — This has been a volatile year for the stock market. But one sector has been consistently earning a windfall for investors: health insurers that provide private Medicare plans to seniors. Read More..
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CMS Introduces Conditional Payment Reimbursement Option

Medicare expands resolution options to include a new Medicare repayment program for small settlements or judgments. This program will be available starting in February 2012 and applies to cases settling for $25,000 or less. Under this program, Medicare will provide final conditional p
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Lawmakers Offer Bipartisan Plan to Overhaul Medicare

WASHINGTON — A Democratic senator, Ron Wyden of Oregon, and a Republican member of the House, Paul D. Ryan of Wisconsin, unveiled a bipartisan plan on Wednesday to revamp Medicare and make a fixed federal contribution to the cost of coverage for each beneficiary. Read More..
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ADEA Exemption For Coordination Of Health Benefits With Medicare Does Not Permit Employer To Terminate Current Employees’ Benefits

from Spencer’s Benefits Reports: The Equal Employment Opportunity Commission’s (EEOC) Age Discrimination in Employment Act (ADEA) exemption for coordination with Medicare applies only to retiree benefits, not the benefits of current employees, the EEOC Office of Legal Counsel staff co
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Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

Several deficit-reduction plans have proposed combining Medicare’s separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries. A new Kaiser Family Fou
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Analyzing Medicare Advantage Competition

Medicare Advantage (MA) and Part D plans are in the midst of marketing their 2012 products to consumers, analyzing how their products compare to competitors and determining how best to deploy sales force resources to maximize opportunities and win new business. With a slightly longer
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Accountable Care Organizations in Medicare and the Private Sector: A Status Update

This issue paper examines the latest developments in accountable care organizations (ACOs), including a look at the final regulations on ACOs issued in October 2011 by the Centers for Medicare & Medicaid Services (CMS). Written by the Urban Institute’s Bob Berenson and Rachel Bur
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2012 Medicare Premiums, Deductibles and Coinsurance

The Centers for Medicare & Medicaid Services (CMS) has announced the changes to the Medicare Part A and Part B premiums, deductibles and coinsurance paid by beneficiaries.1 These changes take effect on January 1, 2012. Read More..
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Medicare Part B 2012 Premiums Lower Than Projected

The Obama administration today announced that premiums for Medicare Part B coverage in 2012 will be $99.90 a month for most beneficiaries, a smaller-than-expected increase over the $96.40 paid this year by a majority of elderly and disabled beneficiaries. Part B pays for physician vis
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