Hospital Health Care

The Centers for Medicare & Medicaid (CMS) now have available to beneficiaries, their caregivers, and family members an online tool to review 2009 Medicare prescription drug plan and health plan information.  The 2009 Plan Finder allows beneficiaries to compare prescription drug coverage from both stand-alone PDP’s and Medicare Advantage plans that provide prescription drug coverage and to view premiums, formularies, and availability of coverage in the gap.  They will also be able to compare Medicare helath plan options, such as HMO’s and PPO’s.

The Center for Medicare and Medicaid Services (CMS) has begun a national coverage analysis of bariatric surgery (gastric bypass) as a treatment for type 2 diabetes to determine whether clinical outcomes justify expanding Medicare reimbursement to patients due to recent findings suggesting that the procedures may help reverse the course of the disease.  Currently, CMS covers bariatric surgery for certain patients, mainly those classified as morbidly obese.

There have been dozens of studies indicating that bariatric surgery may be an effective treatment for type 2 diabetes among patients with lower body mass indices.  There are groups such as the American Diabetes Association and other academic institutions that have urged caution in attributing a benefit to such a procedure without convincing scientific data.  CMS expects to have a final decision on expanding coverage by February 17, 2009.

Do you have Federal Medicare(non-HMO) health coverage and need to use medical services?  If you answered “yes” to this question then it is important for you to understand that you need to make sure that you inform the registrar at the medical facility if you have a second health insurance.  This is important because Medicare is  billed first for payment in most all cases.  There are however certain circumstances where Medicare must be billed second.

If the billing is not done properly, you run the risk of the claim payment being delayed or denied.  This may result in you recieving annoying calls, letters or an unwanted bill.  To learn more about these special conditions to protect yourself, visit hospitalhealthinsurancetoday.com

The Centers for Medicare and Medicaid Services (CMS) is proposing a 47 percent cut by 2010 of the fees paid to physicians in non-hospital cardiac catheterization labs.  This would bring current reimbursement several hundred dollars below the cost of a standard cath procedure.  It is estimated that there will follow closures of these outpatient labs throughout the country.

These closures would create long waits and have a dramatic increase in Medicare beneficiaries patient out-of-pocket costs.  Patients will be forced back into crowded hospital healthcare settings where the costs will be higher.