Medicare Compliance & Reimbursement
Beneficiaries Confused About Part D Benefit
Providers that are having trouble deciphering the Medicare Part D drug benefit have company in their confusion: Senior citizens who the new benefit is supposed to be helping.
There are "serious problems" with how little seniors understand about the drug benefit, says Dan Mendelson, president of Avalere Health in Washington, who says many "don't even know a benefit is coming, and those who do know about it are unlikely to understand how complex it is."
"Awareness is creeping up slowly," says George Kelemen, manager of AARP's Medicare Rx outreach campaign. Research in the spring showed that awareness was quite low, but more recent research shows that the needle is moving, thanks partly to press coverage and the CMS campaign.
Despite the popular confusion about the benefit, PDP sponsors are unlikely to engage in long, drawn-out marketing efforts because of federal rules about when beneficiaries can be enrolled and when certain products are approved.
Plans can launch campaigns to broadly educate beneficiaries about Medicare, but they can't market any particular products too early, says Wayne Rosenberger, senior vice president of health care markets for marketing specialist Harte-Hanks Direct in Langhorn, PA.
Medicare Compliance & Reimbursement
- MEDICARE PART D:
Part D Sponsors Prep For Advertising 'Blitz'
Medicare plans with strong reps are in best market position.
With the new Medicare drug benefit [...] - MEDICARE PART D:
Beneficiaries Confused About Part D Benefit
Lack of knowledge concerns industry insiders.
Providers that are having trouble deciphering the Medicare Part D [...] - MEDICAID:
Study Finds Elderly Patients Getting Subpar Care
Quality of care tethered to physician training, experience.
Few elderly Medicaid patients receive routine preventive health [...] - SKILLED NURSING FACILITIES:
AHCA Doles Out SNF Financing Tips
Organization asks CMS for more level payment differential.
The American Health Care Association is generally pleased [...] - HOSPITALS:
Cuts Cut Both Ways, Hurt Hospitals And Private Payers
Low Medicare, Medicaid payments force hospitals to overcharge commercial plans.
Health plans having a hard time [...] - HOSPITALS:
Payment Increases Highlight Proposed OPPS Rule
Medicare patients could enjoy lower coinsurance rates for outpatient services.
The Centers for Medicare and Medicaid [...] - PAY-FOR-PERFORMANCE:
Docs Will Likely Have To Bend On P4P
Insiders cannot foresee a future without P4P measures.
Washington observers say it's increasingly likely that physicians [...] - DME:
Suppliers Now Allowed To Deliver Home Oximetry Tests
CMS reins in self-testing limits.
Durable medical equipment suppliers will soon be able to deliver [...] - HOME HEALTH:
Day Care Demo Project Comes With Strings
Tab for transport, care must be paid by participating HHA.
Details about the medical adult day [...] - ENFORCEMENT WATCH:
Medicaid Patients Must Verify Home Health Claims
State AG pursues civil fraud lawsuit against a home health facility.
Filing false home health claims [...] - HOME HEALTH:
CMS Says 2-Sheet Review Notices OK
... but providers better use carbonless paper to garner the required exception.
New information about the [...] - BILL WATCH
The following bills were introduced in the Senate: S. 1563. A bill to amend title [...]
