Carter's Benefits

News releases

May 17-2012

Children May Be Responsible For Parents' Long-Term Costs.

Forbes  (5/17, Gleckman) reports, "A Pennsylvania state appeals court has ruled that the adult son of a nursing home resident is responsible for her unpaid $93,000 bill." The state "is one of 30 states that have filial responsibility statutes -- laws that impose a duty on adult children to care for their indigent parents" and "allow long-term care providers to sue family members to recover unpaid costs." However, "federal law prohibits states from going after families after someone is already eligible for Medicaid long-term care benefits or from including an adult child's income and assets when determining whether a parent is eligible for Medicaid."

April 25-2012

Many Fail To Prepare For Long-Term Care.

NPR Morning Edition (4/24) reported that many people find it hard to prepare for the latter years of their parents' lives when their parents may need special care. According to the story, "While aging is inevitable, planning for the costs associated with dependency in the latter phase of life doesn't come easily to most Americans. ... Only 13 percent of some 4,000 US workers surveyed for the 2011 Aflac WorkForces Report believe that the need for long-term care would affect their families." The story quotes Jack Hetherington, a certified elder-law attorney in suburban Philadelphia, as saying, "People dread talking about it because we don't like to face our mortality."

The New York Times (4/25, Carrns) "Bucks" blog reports on rising long-term care insurance premiums and how some beneficiaries use the benefits more than others. In some cases, "the claims paid under the policies total far more than the premiums paid into the policy." The total of the largest long-term care claim was $1.7 million in benefits payout. One reason is because policies were "unlimited" and "lifetime," which have no cap.

April 17-2012
Survey: 6% Of Seniors Use Banned Drug Coupons.

The National Journal (4/17, Subscription Publication) reports, "Six percent of seniors have used coupons to purchase brand name drugs even though Medicare has banned that tactic, according to a survey from the National Coalition on Health Care." NCHC estimates that "if the 6 percent of survey respondents is true of all Medicare recipients," then "2 million Medicare beneficiaries are using coupons to buy drugs that end up costing the government more money." The group's CEO John Rother said in a statement that consumers using the banned coupons "might see lower costs for brand-name drugs, but their health plans still end up paying more to the brand-name manufacturer," which results in "higher costs for everyone."

April 01-2012
HHS Proposes New System For Computing Medicare Wage Index.

Modern Healthcare (4/13, Zigmond, Subscription Publication) reports, "HHS recommends using commuting data to establish a labor market area and wage index value for each hospital as a way to reform the Medicare wage index system, according to a new report (PDF) that HHS Secretary Kathleen Sebelius sent to Congress (PDF)." The report is in fulfillment of a requirement in the Affordable Care Act. In lieu of the Office of Management and Budget's "current wage-index methodology, which uses metropolitan statistical areas," the department is proposing, "a commuting-based wage index," that "would use smaller, more discrete labor areas."

Long-Term Care Insurance Changing, Ever-Important.

Reuters (4/13) reports that long-term care insurance premiums may be rising between 40-90 percent on existing policies, but customers, especially those who are older, should stick with their current plans because it still will be less than the price of a brand-new policy. Some insurers are even ceasing sales of individual long-term care policies because of rising health costs and the regulatory environment. Customers should focus on policies that offer coverage limits of three or five years and forgo inflation protection. Seek long-term care coverage through employers and secure a policy by 50 years of age.

April 01-2012
Author Advocates For End-Of-Life Planning.
Author Susan Jacoby writes in the New York Times (3/31, Subscription Publication), "A third of the Medicare budget is now spent in the last year of life, and a third of that goes for care in the last month. Those figures would surely be lower if more Americans, while they were still healthy, took the initiative to spell out what treatments they do -- and do not -- want by writing living wills and appointing healthcare proxies. ... I consider it my duty, to myself and younger generations, to follow the example my mother set by doing everything in my power to ensure that I will never be the object of medical intervention that cannot restore my life but can only prolong a costly living death."

March 19-2012
HHS: Reform Law Saved Seniors $2.16 Billion On Drugs In 2011.

USA Today (3/19, Kennedy) reports, "Almost 4million seniors saved about $2.16billion through discounts for their prescription medications in 2011, the Department of Health and Human Services plans to announce today. This, administrators say, should help keep costs to the government down in the future. ... The 2010 health care law required a 50% discount on prescription drugs in the so-called doughnut hole, or the gap between traditional and catastrophic coverage in the Medicare drug benefit, also known as Part D."

Krugman: Reform Law Opponents Lack "Honest" Arguments. Paul Krugman, in his column for the New York Times (3/19, Subscription Publication), writes, "It's said that you can judge a man by the quality of his enemies," and "if the same principle applies to legislation, the Affordable Care Act...sits in a place of high honor. ... For all its imperfections, this reform would do an enormous amount of good. And one indicator of just how good it is comes from the apparent inability of its opponents to make an honest case against it."

March 07-2012
AARP: Price Of Popular Drugs Increased 26% From 2005 To 2009.

The New York Times (3/7, Thomas, Subscription Publication) reports that according to a report released Tuesday by AARP, "the prices of drugs used most widely by older Americans rose by nearly 26 percent from 2005 to 2009 -- nearly twice the rate of inflation." The report found that "the increase happened even as the price of generic drugs, which account for the vast majority of prescriptions, has been falling in recent years." AARP senior vice president for policy strategy Cheryl Matheis says that while the "country is contracting economically and inflation is...really low, inflation in the cost of prescription drugs is going in the other direction," illustrating a trend the organization describes as "relentless because it just doesn't seem to abate." Meanwhile, pharmaceutical industry officials criticized AARP's report, asserting that the increased availability of generic drugs has curtailed the increase in drug prices.

February 16-2012
New GOP Medicare Plan Promotes Private Insurance, Increases Eligibility Age And Premiums.

The AP (2/16) reports, "Two Republican senators are unveiling a Medicare rescue plan that features an accelerated transition to private health insurance for many seniors, a gradual increase in the eligibility age, and higher premiums for middle-class and upper-income retirees." The plan by Sens. Tom Coburn (R-OK) and Richard Burr (R-NC) differs from the one proposed by House Budget Committee Chairman Paul Ryan (R-WI) in that it "would start the transition to a system dominated by private insurance plans in 2016 instead of waiting a decade," and seniors "would get a fixed amount from the government which they could apply toward a private plan or the government plan modeled on Medicare."

February 03-2012

GOP Asks AARP For Specific Medicare Reform Proposals.

A letter sent to AARP by congressional Republican physicians requesting specific Medicare reform proposals from the organization is discussed in several Capitol Hill news sources. While two sources portray the GOP lawmakers' request as an implicit criticism of AARP for its role in the Medicare debate thus far, another source suggests it engages the group with a more conciliatory tone than used in previous interactions.

CQ (2/3, Ethridge, Subscription Publication) reports, "GOP members of the House and Senate challenged AARP on Thursday to join their efforts to overhaul Medicare, as House Republicans investigate the powerful advocacy group for possible financial conflicts of interest. The 18 lawmakers -- all medical providers -- wrote to AARP chief executive A. Barry Rand that politics must be put aside in order to find ways to financially bolster Medicare, and they asked the group to identify detailed policy proposals that it would support." AARP Executive Vice President Nancy A. LeaMond "said that the group appreciated the letter and that the lobby would soon ramp up its role in the debate about the future of Medicare."

The Hill (2/3, Baker) reports in its "Healthwatch" blog that the GOP lawmakers' letter states, "Unfortunately, as long as politicians obscure the Medicare program's prognosis for political benefit and stakeholders like AARP fail to publicly challenge these political calculations by educating their membership on the structural financing challenges facing the program, a national conversation about how best to save the Medicare program will not move forward." Furthermore, the Republican doctors "said AARP should have a stronger focus on Medicare's looming insolvency," and want to know "what specific proposals -- in concrete details -- AARP would support to protect its members and the Medicare program." The Hill (2/3, Baker, Pecquet) also reports the story in another "HealthWatch" blog post.

Meanwhile, Politico Pulse (2/3, Millman, DoBias) refers to the Republican lawmakers' approach as "an olive branch" extended to AARP, noting that in April, House Republicans "lit into" the organization "for its endorsement of a popular Medicare supplemental insurance policy." Emphasizing the change in tone, Politico says that in the letter sent Thursday to AARP Chief Executive Barry Rand, Rep. Phil Gingrey (R-GA) and Sen. Tom Coburn (R-OK), both physicians, "struck a more cooperative note." Politico also links to the letter.

HHS: Health Law Has Saved Medicare Recipients Billions On Prescription Drugs.
The Los Angeles Times (2/3, Levey) reports that according to the Obama administration, "in the first full year of the new healthcare law, 3.6 million people in the government Medicare program saved $2.1 billion on prescription drugs in 2011," which is "one of the first tangible benefits of the sweeping overhaul that the president signed in March 2010." Secretary of Health and Human Services Kathleen Sebelius said, "As we move forward, we will close the doughnut hole completely, and save even more money for everyone with Medicare." CQ (2/3, Norman, Subscription Publication) provides the HHS press release.

The Hill (2/3, Pecquet) reports in its "Healthwatch" blog, "The announcement is part of the White House's strategy to roll out good news about the healthcare law ahead of the November election - particularly regarding young adults, who are most likely to support President Obama, and seniors, who are most likely to vote. ... The plan is not only intended to boost the law's popularity, but also to put GOP presidential candidates on the spot for vowing to repeal all of it, including its most popular provisions."

The Orlando Sentinel (2/3) reports, "Nearly 240,000 Medicare patients in Florida saved nearly $142 million on their prescription drugs last year through a provision in the health-care overhaul that has already taken effect, US Secretary for the Department of Health and Human Services Kathleen Sebelius announced Thursday in Orlando." The Miami Herald (2/3) also reports Florida's numbers.

The Detroit News (2/3, Burden) reports, "More than 84,000 Michigan residents receiving Medicare benefits saved nearly $49 million on prescriptions in 2011 under health care reform, the US Department of Health & Human Services said Thursday."

The Contra Costa (CA) Times (2/3, Steinberg) reports, "The act saved 319,429 Californians $171,983,735, or an average of $538, the government said in a statement." Gerald F. Kominski, director of the UCLA Center for Health Policy Research, remarked, "It calls to our attention the fact that health care reform has already affected millions of Americans."

The Kansas City Business Journal (2/3, Twiddy, Subscription Publication) reports, "HHS said in a release that the law affected 38,692 Kansas recipients who saved a total of $23.4 million, or an average of $606 each, on prescription drug costs in 2011. In Missouri, 78,585 recipients saved a total of $46.8 million, or $595 a person."

The Salt Lake (UT) Tribune (2/3, Stewart) reports, "Utah lawmakers had hoped to save up to $8 million last year by steering Medicaid patients to a 'preferred list' of less-expensive prescription medicines. But the payoff was even greater: $27.6 million in fiscal year 2011, according to new Utah Department of Health data."

The Idaho Statesman (2/3) reports, "Changes to Medicare under the 2010 health care reform law have saved 14,963 Idaho residents $8.7 million - or $579 each - in prescription drug costs, the US Department of Health and Human Services says."

The Wall Street Journal (2/3, Radnofsky) "Health" blog and Modern Healthcare (2/3, Zigmond, Subscription Publication) also report this story.

December 05-2011
Proposed House Bill To Increase Medicare Premiums For Wealthy Seniors.
In a story carried by more than 160 news sources, the AP (12/7, Espo) reports that according to officials, "House Republicans intend to propose a gradual increase in Medicare premiums for wealthy seniors to help cover the cost of renewing Social Security payroll tax cuts and benefits for the long-term unemployed." The piece notes that "Republicans oppose higher taxes, and GOP aides in the House pointed out that the proposed higher Medicare premiums for the wealthy would fall on some of the same individuals whom Democrats want to tax."

Medicare Recipients Said To Be Benefitting From Healthcare Reform.

In a front-page story, USA Today (12/6, A1, Kennedy) reports that the government plans to announce that "more than 2.65 million Medicare recipients have saved more than $1.5 billion on their prescriptions this year, a $569-per-person average, while premiums have remained stable." In addition, "as of the end of November, more than 24 million people, or about half of those with traditional Medicare, have gone in for a free annual physical or other screening exam since the rules changed this year because of the health care law." Jonathan Blum, director of the Center for Medicare, remarked, "We're very pleased with the numbers. We found the Part D premiums have also stayed constant, despite predictions that they would go up in 2012."

November 22-2011
Plan To Control Medicare Costs Emerges From Supercommittee Debate.

The New York Times (11/25, Pear, Subscription Publication) reported that, while failing to reach an agreement on deficit reduction, the Supercommittee did hear arguments "for major structural changes in Medicare that would limit the government's open-ended financial commitment to the program, lawmakers and health policy experts say. Members of both parties told the panel that Medicare should offer a fixed amount of money to each beneficiary to buy coverage from competing private plans, whose costs and benefits would be tightly regulated by the government." Though "many Democrats" argue the plan "would shift costs to beneficiaries and eliminate the guarantee of affordable health insurance for older Americans," others in the party "say that - if carefully designed, with enough protections for beneficiaries - it might work."

Medicare Prescription Coverage Gap Decreasing.

In a story covered by more than 410 news sources, the AP (11/28, Alonso-Zaldivar) reports, "Medicare's prescription coverage gap is getting noticeably smaller and easier to manage this year for millions of older and disabled people with high drug costs." Tricia Neuman, director of Medicare policy for the nonpartisan Kaiser Family Foundation, remarked, "For people with high drug expenditures, the 50 percent discount offers real savings. It's certainly more helpful than no coverage at all, which is what they had previously."

November 22-2011
Retirement Activists Suggests Maximizing Roth IRA For Healthcare Needs.

In a piece for Forbes (11/22), retirement activist Robert Laura recommending that in order "to address healthcare concerns and future living costs," soon-to-be retirees should "maximize their funding of a Roth IRA and consider taking a more aggressive, long-term stance with the investments inside of it." Laura adds, "Funding a Roth for future medical costs can also help early retirees bridge the gap between employer-provided health insurance and the time when they become eligible for Medicare. One of the biggest reasons people put off early retirement rests with their inability to find or afford individual health coverage. With a healthy Roth IRA account balance, however, you can leave work at age 63½ and exercise your employer's 18-month COBRA option to bridge the coverage gap, while ideally paying for it tax free from your Roth."

November 14-2011

Congress Pressured To Restructure Medicare.

CQ (11/14, Reichard, Subscription Publication) reports, "Congress faces enormous pressure to restructure Medicare after the next election regardless of how deeply the deficit reduction package ends up reducing the cost of the entitlement program" because "Medicare's costs are on track to jump at least a projected 6 percent a year, dwarfing whatever level of savings the budget control law (PL 112-25) produces through automatic cuts or a proposal being developed by the Joint Select Committee on Deficit Reduction."

November 10-2011
Democrats Propose Cutting $400 Billion In Medicare, Medicaid Spending.

CQ (11/10, Ethridge, Subscription Publication) reports, "As part of back-and-forth negotiations, Democrats on the joint deficit reduction committee proposed cutting $400 billion in Medicare and Medicaid spending on Monday, as part of a broader proposal to pare $2.3 trillion from the deficit over 10 years." The proposal "calls for using a portion of expected savings from winding down the wars in Iraq and Afghanistan to help prevent a scheduled 27.4 percent cut in the reimbursement rate next year for physicians who see Medicare patients." Several "medical provider groups and advocates for seniors have repeatedly called on the joint committee to address the scheduled cuts, but many have hoped the panel would overhaul the current formula, known as the sustainable growth rate."

November 07-2011
Increasing Medicare Eligibility Age Would Impact Seniors' Social Security.

The Hill (11/4, Pecquet) "Healthwatch" blog reported, "Increasing the eligibility age for Medicare to 67 would take a big chunk out of seniors' Social Security, according to a new report (pdf) that aims to link the two unpopular proposals together." Recently, "the group Strengthen Social Security calculated that increasing the eligibility age, as some have urged the deficit-cutting supercommittee to do, could consume up to 45 percent of middle-class seniors' Social Security check. The numbers are based on a previous Kaiser Family Foundation analysis that found that 3.3 million people ages 65 and 66 would pay more out of pocket for healthcare if they were no longer eligible for Medicare."

November 01-2011
Poll: Majority Of Voters Oppose Medicare Cuts, Higher Copayments.

The National Journal (11/1, Joseph, Subscription Publication) reports, "As the Super Committee works away at a plan to cut over $1 trillion from the federal budget, a new poll shows that 83 percent of voters oppose cuts to Medicare and higher beneficiary copayments." Additionally, the survey "found that about 70 percent of voters think that the government should do more to cut waste, fraud and abuse in Medicare and Medicaid spending." Notably, "the poll of 1,000 voters was commissioned by Fight Fraud First, a coalition made up of groups including AARP that is urging the Super Committee to root out waste and fraud in Medicare and Medicaid before cutting funding for the programs or increasing copayments."

Debt Panel's Targets Seen As "Generational War." Bloomberg News (11/1, Przybyla) says that while "the elderly will likely be the most vulnerable Americans in Washington's future budget fights," for the time being, "their grandchildren may be among the biggest casualties. With Democrats and the 37 million-member AARP seniors' lobby," which "spent $9.7 million on lobbying during the first six months of this year," endeavoring "to protect Medicare and Social Security, and Republicans opposing tax increases to curb the deficit, programs for young people may be disproportionate targets if negotiators can't reach a budget deal and automatic spending cuts kick in." Disagreeing with those who criticize AARP for "squeezing the heck out of the future" and "programs for kids," the organization's legislative policy director David Certner says its "members and all older Americans depend on their hard-earned Medicare and Social Security benefits, and want these vital programs to be strong now and for future generations."

October 15-2011
"Modest" Increase In Medicare Premiums Announced.

The announcement regarding Medicare premiums received extensive and mostly positive coverage, as officials and experts expressed satisfaction that the increase is smaller than expected. The CBS Evening News (10/27, story 6, 0:25, Pelley) reported, "Last week, we told you Social Security recipients are getting a raise tied to the inflation rate. Well, today we hear that seniors will be paying more for Medicare premiums next year. The government raised the basic monthly payment for Part B to $99.90 and for most folks that's an increase of about $3.50 a month."
The New York Times (10/28, A15, Pear, Subscription Publication) reports, "Administration officials rejoiced at the modest increase, which could pay political dividends to President Obama as he tries to win the votes of older Americans in his bid for re-election." Furthermore, "officials said the smaller increase showed their prudent management of the program, using tools provided by the new health care law to control costs." The Times quotes Jonathan D. Blum, deputy administrator of the federal Centers for Medicare and Medicaid Services, who "said officials were seeing 'much lower utilization and spending growth' in Medicare than they had expected."
The Wall Street Journal (10/28, A6, Radnofsky, Subscription Publication) cites HHS Secretary Kathleen Sebelius, who said that retirees could see about $40 more each month because of a higher Social Security benefit coupled with the smaller Medicare premium increase. The AP (10/28, Alonso-Zaldivar) reports that according to Sebelius, it is "pretty remarkable" that the premiums will remain low. She remarked, "Thanks to the Affordable Care Act, Medicare is providing better benefits at lower cost."
The Boston (MA) Globe (10/28, Kotz) "Daily Dose" blog reports that "Sebelius called the lower-than-expected premium increase 'the latest round of good news' and added that the projected increases in Medicare costs were lower than expected partly because of greater competition among health plan providers put in place by the Affordable Care Act."
The Hill (10/28, Pecquet) reports in its "Healthwatch" blog, "CMS Administrator Donald Berwick said the lower-than-expected premiums hike was due to two principal factors: historically low healthcare utilization rates, due in part to the healthcare reform law's investment in prevention and the 3.6 percent Social Security cost-of-living (COLA) hike announced earlier this month." In a statement, Rep. Pete Stark (D-Calif.), said, "These reductions are a direct result of the Medicare reforms included in the Affordable Care Act – further affirmation of the positive impact health reform is already having on Americans' pocketbooks."
The Washington Times (10/28, Cunningham) quotes Berwick, who said, "We are excited about being able to offer people better Medicare at less cost. That just makes sense."
The Washington Post (10/28, Kliff) reports, "The announcement was the third piece of good news about Medicare premiums this year." AARP's legislative policy director, David Lerner, remarked, "This small increase is welcome news."
        Also covering the story were the Baltimore Sun (10/28), Reuters (10/28, Selyukh), Bloomberg News (10/28, Eisenberg), CQ (10/28, Adams, Subscription Publication), and Modern Healthcare (10/28, Zigmond, Subscription Publication).

October 15-2011

Tips For Selecting 2012 Medicare Part D Plan Reviewed.

US News and World Report (10/25, Brandon) offers seven "tips for picking a 2012 Medicare Part D plan," suggesting that consumers "consider switching into a plan with lower costs or better coverage next year." Saying that "there is a wide variation in annual premium changes," the article notes that "the more than 4.6 million enrollees in UnitedHealth's AARP Preferred MedicareRx prescription drug plan will see a 14 percent increase in their premium in 2012, to $39.70, if they remain in this plan." Meanwhile, "Humana's low-premium Walmart-Preferred Rx Plan will increase premiums by 2 percent, to $15.10 in 2012."

October 17-2011

Medicare Open Enrollment Started On Saturday.

The Wall Street Journal (10/16, Greene, Subscription Publication) reported on the start of the 2012 Medicare open enrollment period on Saturday. Changes from 2011 include an earlier deadline and different, sometimes more complicated rules. The Journal detailed Medicare Parts A, B, C, D and what they entail, as well as what the patient needs to do when signing up.
        The NPR (10/15, Torres) "Shots" blog reported, "Beneficiaries now have seven weeks, rather than six, to decide on plans, and the earlier deadline should make it more easier to get people their new membership cards by the start of 2012. There is, however, one exception to the new deadlines: Beneficiaries who switch to a 5-star Medicare Advantage plan -- the highest-rated for quality, as determined by CMS -- can do so at any time during the year." The new deadline is Dec. 7, earlier than the previous Dec. 31, but the enrollment period is a week longer than before.
        Berwick Discusses CMS, Medicare Advantage. The Detroit Free Press (10/16, Anstett) printed "excerpts from an interview with Dr. Don Berwick, administrator of the Centers for Medicare & Medicaid Services in Baltimore." Among other information, Dr. Berwick noted that "the Medicare Advantage program remains strong and stable for fiscal 2012, and premiums on average are decreasing." He pointed out that "beginning with the 2014 plan year, Medicare Advantage plans with a medical loss ratio (medical cost as a percentage of revenue) of less than 85% will be required to return a portion of their revenue."
        Program To Help Seniors Learn About Medicare Options. The Detroit Free Press (10/17, Anstett) reports on "a network of seminars scheduled through December through the federally funded Medicare Medicaid Assistance Program" to help people learn about their Medicare options. "The events allow seniors to sit with counselors for one-on-one advice about the best plans for them by comparing the price of drugs a senior uses and other benefits. The seminars also help eligible seniors apply for financial help for Medicare programs, including programs that give deep discounts or even free medicines to low-income seniors."

Supercommittee May Consider Proposal On Medigap Policies.
CQ (10/15, Norman, Subscription Publication) reported, "Requiring Medicare recipients to pay more for medical services is one way to ensure they have 'skin in the game' and think twice about the need to see a doctor or get a costly medical test, experts say." This notion "is driving a leading proposal to overhaul private supplemental insurance plans, known as Medigap policies, that is likely to be considered by the Joint Select Committee on Deficit Reduction. The idea of using economic consequences to limit the health services seniors seek has bipartisan backing, particularly among deficit hawks, but it also has powerful opponents." Typically, "Medigap policies cover the full cost of almost all medical services not covered by Medicare's traditional fee-for-service program."

September 28-2011
Social Security Update for 2012: COLA Wash
For most of the 45 million Americans who receive both Social Security and Medicare benefits, 2012 will be yet another year with effectively no increase in their Social Security payments. Although the government is anticipating a small cost-of-living increase next year, because of increases in Medicare Part B premiums, which are deducted from Social Security payments for those receiving both benefits, an estimated three-fourths of beneficiaries will see their COLAs eaten up by higher premiums. Read more

September 26-2011

Analysis: Average Cost Of Medicare Part D Plans Decreasing By 4%.

The Hartford Courant (9/24, Sturdevant) reported, "Prices for prescription-drug coverage for Medicare recipients are dropping by 4 percent on average across all plans, according to an analysis" conducted by Avalere Health. But, the "top two insurers by membership...are increasing prices for Medicare Part D." Notably, "AARP MedicareRx Preferred plans offered by UnitedHealth Group are increasing monthly premiums by 14 percent to $39.70 next year from an average of $34.82 this year."

September 14-2011
Medicare Enrollment To Begin, End Earlier This Year.

The Salt Lake Tribune (9/14, Henetz) reports, "Federal and state officials are still working on the details, but Medicare beneficiaries should be prepared for changes in this year's annual open enrollment period." Recipients -- "those using traditional Medicare, private Medicare Advantage plans, prescription drug and Medigap supplemental coverage -- are allowed each year to make changes to their coverage." But, because of "provisions in this year's Affordable Care Act, the open enrollment period will begin and end earlier than in previous years." In 2011, "open enrollment begins Oct. 15 and runs through Dec. 7."

September 13-2011
CVS To Provide Uninsured With Flu Shots.
The AP (9/13) reports, "CVS Caremark Corp. said Monday it will give away up to $6 million in seasonal flu shots to people who don't have health insurance." According to the company, "vouchers for the vaccination will be available at 400 clinics and health centers around the country."

CMS To Reward Five-Star Medicare Advantage Plans With All-Year Enrollment.
The Hill (9/13, Baker) reports in its "Healthwatch" blog from the annual meeting on Medicare and Medicaid of America's Health Insurance Plans where Jonathan Blum, deputy administrator at the Centers for Medicare and Medicaid Services, announced that as of next year, "Medicare Advantage plans with a five-star quality rating from CMS will be able to market their policies - and enroll new customers - all year" instead of during a limited enrollment period. Also, "CMS will begin using graphical warnings to identify consistently low-performing policies," and will be updating ratings to give "more weight to metrics that measure outcomes and patient satisfaction." Blum also noted, "When we weight more by outcomes ... more plans are deemed to be five-star."
Plans See Continuing Growth. Kaiser Health News (9/13, Weaver) reports in its "Capsules" blog on a Kaiser Family Foundation report finding that enrollment in "private Medicare health plans is continuing to grow, despite steep cuts enacted in the 2010 federal health law," with "nearly 12 million of the nation's 47 million Medicare enrollees are now in private plans, up from 11 million last year." With the cuts, "the chief actuary for the Centers for Medicare & Medicaid Services predicted enrollment in the private plans would drop to about 7.4 million by 2017." But interviews with "executives with 14 firms that run Advantage plans" found that "the execs' read on the program remains 'cautiously optimistic.'" One reason for that is that the law that brought cuts also "promised bonus payments to plans with good performance" and those have had the effect of "offsetting the cuts."

September 09-2011
Sebelius Touts Health Reform Benefits For Seniors.

CQ (9/9, Adams, Subscription Publication) reports, "About 18 million people in fee-for-service Medicare received a free preventive service during the first seven months of this year, and nearly 1.3 million beneficiaries received a discount on their brand-name prescription drugs when they hit a Medicare coverage gap, according to new estimates released by the Department of Health and Human Services." These benefits are the result of provisions in the healthcare law, and HHS Secretary Kathleen Sebelius "is touting" them "when she talks to senior citizens' groups, a politically important lobby."
        Modern Healthcare (9/9, Zigmond, Subscription Publication) reports that "by the end of August, about 1.3 million people in the program had had an annual wellness visit -- a provision in the healthcare reform law for which there is no co-payment or cost-sharing -- which represents an increase of about 23% from the 1.06 million beneficiaries who used the benefit as of the end of July."

August 19-2011
Medicare Part D Premiums Expected To "Fall Slightly."

In the New York Times (8/19) "The New Old Age" blog, Paula Span says, "In a slightly desperate hunt for good economic news, I've come up with this small consolation: Average premiums for Medicare Part D, the prescription drug benefit, will not rise in 2012." Rather, "they will fall slightly," she predicts. Discussing her hypothesis, Span notes that "main cost-control factor is Medicare's heavy use of generic drugs, the agency says, along with competition, as insurers bid against one another to attract customers, plus the inflation-busting effects of lingering recession."

Augustl 16-2011
CMS Urged To Investigate Over-Prescribing Of Antipsychotics In Nursing Homes.

MedPage Today (8/15, Walker) reports Sens. Charles Grassley (R-IA) and Herb Kohl (D-WI) "have urged the Centers for Medicare and Medicaid Services (CMS) to take a closer look at potential over-prescribing of atypical antipsychotics to nursing home residents." In a letter to CMS administrator Donald Berwick, MD, Grassley and Kohl request "that CMS investigate what role pharmacy benefit managers -- who manage prescription drug coverage for Medicare beneficiaries living in nursing homes -- play in fueling the possible overuse of atypical antipsychotics in elderly people in long-term-care facilities." MedPage Today notes, "The letter is a follow-up to one the senators sent in May after the release of the OIG report, which the senators themselves requested."

April 26-2011
Seniors Not Using Free Benefits Provided By Healthcare Law.

The Washington Post /Kaiser Health News (4/26, Jaffe) reports, "Starting this year, seniors enrolled in Medicare no longer have to pay for more than a dozen tests and other services to help prevent or control cancer and other costly and debilitating diseases. These benefits, which also include an annual wellness exam, are part of the new federal health-care law." Yet, large numbers of seniors "aren't lining up for free mammograms or colonoscopies, although early data indicate that the free wellness checkup is luring patients." Jonathan Blum, deputy administrator at the Centers for Medicare and Medicaid Services, said, "Our hope is that by waiving cost-sharing and making preventive care more affordable, more beneficiaries will get it." Another Washington Post /Kaiser Health News (4/26, Jaffe) piece provides a list of the free Medicare services available under the healthcare law.

April 19-2011
"Ask Medicare" Website Revamped.
In the New York Times' (4/18, Subscription Publication) "The New Old Age" blog, Paula Span says that while Medicare.gov "gets up to 2.8 million visitors a month," Ask Medicare, "the section devoted to family caregivers, has been drawing far less interest" and "the section was 'hard to navigate and hard to read,' said Brian Smart, account manager for the Centers for Medicare and Medicaid Services." Medicare "spent months revamping Ask Medicare, and the new-and-improved version made its debut last week."

Another USA Today (4/19, Copeland) article reports, "A wave of Americans face the end of their driving lives and communities around the USA are working to keep seniors mobile and avoid depression-inducing isolation that often accompanies the end of driving." Deborah Hersman, "chairman of the National Transportation Safety Board, which last fall became the first federal safety agency to analyze the issue of mature drivers," says that although it remains "a real challenge in...both rural and urban" parts of the country, "people who (remain mobile) have the ability to be independent longer." According to a report from the National Institutes of Health, "about 7 million older Americans suffer from depression," and experts say "the social isolation caused by loss of mobility is often a factor." The article highlights "efforts to help" combat the problem.

The Wall Street Journal (3/24, subscription required) editorializes that a recent decision by Judge Rosemary Collyer stating that Americans who accept Social Security benefits must also enroll in Medicare illustrates the path the healthcare law will take. In the lawsuit, senior citizens stated that they wanted to opt out of Medicare and still retain Social Security. The Journal says this illustrates how the government would rather force a substandard healthcare option on seniors rather than giving them a choice to pay for their own private health insurance.

March 17-2011
HHS Report Finds More Seniors Are Using Benefits Under Healthcare Law.

The Hill (3/16, Millman) "Healthwatch" blog reported that about "150,000 seniors in the past two months have received a free annual wellness visit, one of the healthcare reform law's benefits that administration officials and Democrats have been eager to tout." A recently released report from the Department of Health and Human Services noted the savings seniors received. The Hill added that the "report comes a week before the one-year anniversary of the law's enactment." Notably, the HHS Secretary Kathleen Sebelius testified before the Senate Finance Committee on Wednesday noting the benefits of the healthcare law.

HealthDay (3/15, Preidt) reported, "Many Americans aged 65 and older are not receiving potentially lifesaving preventive health services, says a new report by several US Department of Health and Human Services agencies." Specifically, "too few seniors are getting recommended vaccinations for influenza and pneumococcal disease, including bloodstream infections, meningitis and pneumonia; help with quitting smoking; or screenings for breast cancer, colorectal cancer, diabetes, high cholesterol and osteoporosis, according to the report released March 14." In a news release, study author Lynda Anderson, director of the Healthy Aging Program at the US Centers for Disease Control and Prevention, stated, "Millions of Americans are not getting proven clinical preventive services that we know can prevent disease and improve quality of life."

December 14-2010
Some Seniors To Pay Higher Medicare Costs Due To Healthcare Law.
CQ HealthBeat (12/14, Adams, subscription required) reports, "The percentage of Medicare seniors who will have to pay a higher premium for Part B outpatient services will increase from about 5 percent in 2011 to 14 percent in 2019 because of changes put in place by the health care law that base beneficiaries' premiums on their incomes, according to a new analysis for the nonpartisan Kaiser Family Foundation." In addition, "higher-income seniors...will have to pay higher fees for their drug coverage for the first time, with about 3 percent of enrollees in 2011 and 9 percent in 2019 facing the higher costs." CQ notes, "The law also will begin to tie Part D drug costs for seniors to their incomes for the first time."

November 02-2010

Seniors Urged To Review Options For Medicare Part D.

Michelle Andrews writes in a Washington Post /Kaiser Health News (11/2) column, "This month marks the beginning of the annual enrollment time for the Medicare Part D program, when beneficiaries can try to pick the plan that provides the best coverage for their prescription drugs." Yet, "even though switching plans may sometimes be a smart move, says Dan Mendelson, chief executive of Avalere Health, a consulting firm based in Washington, 'seniors are remarkably passive when it comes to changing plans.'" Experts say that seniors should not hesitate to change if necessary, "in part because...the health-care overhaul law" includes "some changes in the Part D program that may affect" their "out-of-pocket costs and coverage for 2011."

Administration's Medicare Requirements Too Stringent, Courts Say.
The New York Times (11/2, A21, Pear) reports, "Two federal courts have ruled that the Obama administration is using overly strict standards to determine whether older Americans are entitled to Medicare coverage of skilled nursing home care and home healthcare." Therefore, "Medicare will pay for those services if they are needed to maintain a person's ability to perform routine activities of daily living or to prevent deterioration of the person's condition, the courts said," and "Medicare beneficiaries do not have to prove that their condition will improve, as the government sometimes contends." The Times says that these "rulings are potentially significant for many people with chronic conditions and disabilities like multiple sclerosis, Alzheimer's disease and broken hips." Meanwhile, the Administration has not yet indicated if it will "appeal either decision."

Seniors Urged To Begin Considering Medicare Part D Plans Now.
The Los Angeles Times (10/18, Kritz) reports, "The sign-up period for Medicare Part D (Medicare's prescription drug program) for 2011 runs Nov. 15 to Dec. 31," and seniors are urged to begin considering their options early. "Eligible seniors (anyone with Medicare Part A and/or Part B) can choose from among several dozen plans in their area," and "each covers different lists of drugs and has different costs for premiums, deductibles and co-pays." Notably, "there are a lot of plans to review -- an average of 33 per state, according to the Kaiser Family Foundation."

Part D Premiums May Not Rise As High In 2011 As Initially Thought. The Hill (10/15, Lillis) "Healthwatch" blog reported, "Costs for most seniors enrolled in Medicare's prescription drug benefit won't jump nearly as high next year as initially thought, an independent group reported this week." Avalere Health, a policy group, "estimates the average monthly premium for Part D's top 10 plans (by enrollment) will rise 0.2 percent in 2011 - a far cry from the 10 percent hike the same group estimated last month." Avalere said Friday "that the September estimate assumed current enrollees in First Health plans that won't be offered next year would be automatically switched into the company's Premier Plus plan (and therefore face the 43 percent premium hikes)." Instead, "Medicare intends to switch those beneficiaries into First Health's Premier plan."

Medicare Plan Selection May Be Complicated By Healthcare Law.
Reuters (10/14) reported that now is the time for seniors to purchase new Medicare Part D plans, or switch from current ones. Therefore, they are being inundated by sales pitches from various providers of these plans, and selecting the right plan may be more complicated because of the new healthcare law. Reuters noted that seniors are not required to have these plans which cover prescription drugs, but data show that 25% of them select Medicare Advantage plans, which include prescription drug coverage.

Fewer Medicare Plan Options Expected For 2011. The Palm Beach Post (10/15, Green) reports, "Medicare options for next year are being unveiled today, and there will be fewer choices than last year," although "that may not be a bad thing." The Post adds, "In a comparison of plans available beginning today, 47 Medicare Advantage plans offered by private insurers include drug coverage, down from 56 in 2010. Medical plans without drug coverage dropped from 15 to 10 and drug-only coverage offerings fell from 47 to 32." Lee Millman, a spokesman for CMS' regional affairs office, said, "That's 'not necessarily bad news."

CMS Debuts New Feature On HHS Health Website.
fcw.com (10/13, Lipowicz) reported, "The Centers for Medicare and Medicaid Services has launched a new feature on the MyMedicare.gov secure website that enables 47 million Medicare beneficiaries to view, download and print their complete medical records, officials announced." Notably, the "CMS 'Blue Button' download feature is similar to the Veterans Affairs Department's debut of a Blue Button capability on its MyHealtheVet website in August." Its "capabilities are open government initiatives by both agencies in response to calls from the Markle Foundation and advocacy groups to allow patients greater access to their personal medical data."