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Musical interlude...

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1Musical interlude... Empty Musical interlude... 2/21/2014, 8:21 pm

Floridatexan

Floridatexan


2Musical interlude... Empty Re: Musical interlude... 2/21/2014, 8:29 pm

Floridatexan

Floridatexan

3Musical interlude... Empty Re: Musical interlude... 2/21/2014, 8:38 pm

Floridatexan

Floridatexan

4Musical interlude... Empty Re: Musical interlude... 2/21/2014, 8:50 pm

Floridatexan

Floridatexan

5Musical interlude... Empty Re: Musical interlude... 2/21/2014, 8:55 pm

Floridatexan

Floridatexan

6Musical interlude... Empty Re: Musical interlude... 2/21/2014, 8:58 pm

Floridatexan

Floridatexan


Don't mind me...I'm just entertaining myself...or feel free to jump in at any time...

This song is dedicated to TEOKWWWWhatever...

7Musical interlude... Empty Re: Musical interlude... 2/21/2014, 9:00 pm

dumpcare



Bohemian

8Musical interlude... Empty Re: Musical interlude... 2/21/2014, 9:03 pm

dumpcare



moody blues



9Musical interlude... Empty Re: Musical interlude... 2/21/2014, 9:09 pm

dumpcare



southern cross

10Musical interlude... Empty Re: Musical interlude... 2/21/2014, 9:17 pm

Floridatexan

Floridatexan

11Musical interlude... Empty Re: Musical interlude... 2/21/2014, 9:48 pm

2seaoat





one of my background memorial songs which I have asked my wife to play. I have thought of placing my ashes in a wooden box on a slightly tilted table.

12Musical interlude... Empty Re: Musical interlude... 2/21/2014, 9:58 pm

dumpcare



These are two I want played at mine.







13Musical interlude... Empty Re: Musical interlude... 2/21/2014, 10:06 pm

Floridatexan

Floridatexan

I want to thank you, PPACA, for trying to provide a sane assessment of the new healthcare laws. I haven't applied yet...but will soon. I hope the changes to the law are beneficial to you...I knew it wasn't going to be a smooth transition...












i

14Musical interlude... Empty Re: Musical interlude... 2/21/2014, 10:08 pm

Floridatexan

Floridatexan

ppaca wrote:These are two I want played at mine.








I can play the second one.

15Musical interlude... Empty Re: Musical interlude... 2/21/2014, 10:21 pm

dumpcare



Floridatexan wrote:I want to thank you, PPACA, for trying to provide a sane assessment of the new healthcare laws.  I haven't applied yet...but will soon.  I hope the changes to the law are beneficial to you...I knew it wasn't going to be a smooth transition...

Before March 15th for April 1 effective date and March 31st for a May 1 effective then that is the end of open enrollment until Nov 15th.

I am right in the middle of this as you can see by some of my posts, it could have been presented in a much better manner and they should have read the damn thing before voting on it. It is not affordable to anyone not receiving a subsidy and they have it set up that it is not fair to someone under 50 in the exact same poverty level % as someone over 50, does not calculate the same subsidy. All anyone know's is if you are in that cone of 100% to 400% you will receive a subsidy and that isn't so. If they were going to do something it should have been Medicare for all, I can't see where it would have cost anymore (in fact maybe less) than what is going on now.

The changes have not effected me yet I am over 65, but that is coming down the road. For business it was the pitts.

Thanks












i

16Musical interlude... Empty Re: Musical interlude... 2/21/2014, 10:33 pm

Guest


Guest

Floridatexan wrote:I want to thank you, PPACA, for trying to provide a sane assessment of the new healthcare laws.  I haven't applied yet...but will soon.  I hope the changes to the law are beneficial to you...I knew it wasn't going to be a smooth transition...

i

Pay attention. maybe you should send him some cash. this is what he said earlier today. hope youre happy.

ppaca wrote:No you make a lot of assumptions, I was just screwing with and I do know perfectly well that all the group plans in the state of Florida and many other's are being increased this year up into the double digits and yes it's because of obamacare. I have already gotten mine in every way imaginable since Oct 1. I have basically been out of business since Oct 1, yes one here or there, but it is over.

17Musical interlude... Empty Re: Musical interlude... 2/21/2014, 10:45 pm

TEOTWAWKI

TEOTWAWKI

Floridatexan wrote:
Don't mind me...I'm just entertaining myself...or feel free to jump in at any time...

This song is dedicated to TEOKWWWWhatever...


Here since you don't love me anymore....




18Musical interlude... Empty Re: Musical interlude... 2/21/2014, 10:58 pm

dumpcare



Dot wrote:
Floridatexan wrote:I want to thank you, PPACA, for trying to provide a sane assessment of the new healthcare laws.  I haven't applied yet...but will soon.  I hope the changes to the law are beneficial to you...I knew it wasn't going to be a smooth transition...

i

Pay attention. maybe you should send him some cash. this is what he said earlier today. hope youre happy.

ppaca wrote:No you make a lot of assumptions, I was just screwing with and I do know perfectly well that all the group plans in the state of Florida and many other's are being increased this year up into the double digits and yes it's because of obamacare. I have already gotten mine in every way imaginable since Oct 1. I have basically been out of business since Oct 1, yes one here or there, but it is over.

Yea cash will work Chrissy, maybe I can get rid of the flies and herpes.

Yes I said all that, I was just messy with you when you were pissed over your group rates going up. I believe months ago I said rates on groups would be double digit increases and I also have said before unless you have a subsidy the prices for individual are quite high. I have tried to keep an open mind on both sides of this, since I do see some good things about it, but really very few. I do see it helping someone in their late 50's or early 60's using this to bridge a gap until Medicare eligible. I  don't believe it will remain in it's present form in 3 years, regardless of which party wins in the elections.

I know several have said the insurance company's are in bed with obama, if they are they are they have been in collusion also to get rid of the agent. That I firmly believe. You don't see many advertisements, Call an Agent and he/she will help you enroll, in fact other than a few print materials one company has sent out I haven't seen any. The govt is pushing unlicensed navigator's who can't even spell insurance and the insurance company's have not fought this one bit.

I argue both sides sometime's, but one thing for certain this has created about 200,000 very pissed off insurance agents across the country. You can take about half of that figure and really add to the unemployment roles, their incomes have been cut in more than half. Quite a few I know are now working this part time and have another job. This will be the end of the health insurance agent.

But not everything you read Chrissy is the truth about it, good or bad.

19Musical interlude... Empty Re: Musical interlude... 2/21/2014, 11:11 pm

Guest


Guest

ppaca wrote:
Dot wrote:
Floridatexan wrote:I want to thank you, PPACA, for trying to provide a sane assessment of the new healthcare laws.  I haven't applied yet...but will soon.  I hope the changes to the law are beneficial to you...I knew it wasn't going to be a smooth transition...

i

Pay attention. maybe you should send him some cash. this is what he said earlier today. hope youre happy.

ppaca wrote:No you make a lot of assumptions, I was just screwing with and I do know perfectly well that all the group plans in the state of Florida and many other's are being increased this year up into the double digits and yes it's because of obamacare. I have already gotten mine in every way imaginable since Oct 1. I have basically been out of business since Oct 1, yes one here or there, but it is over.

Yea cash will work Chrissy, maybe I can get rid of the flies and herpes.

Yes I said all that, I was just messy with you when you were pissed over your group rates going up. I believe months ago I said rates on groups would be double digit increases and I also have said before unless you have a subsidy the prices for individual are quite high. I have tried to keep an open mind on both sides of this, since I do see some good things about it, but really very few. I do see it helping someone in their late 50's or early 60's using this to bridge a gap until Medicare eligible. I  don't believe it will remain in it's present form in 3 years, regardless of which party wins in the elections.

I know several have said the insurance company's are in bed with obama, if they are they are they have been in collusion also to get rid of the agent. That I firmly believe. You don't see many advertisements, Call an Agent and he/she will help you enroll, in fact other than a few print materials one company has sent out I haven't seen any. The govt is pushing unlicensed navigator's who can't even spell insurance and the insurance company's have not fought this one bit.

I argue both sides sometime's, but one thing for certain this has created about 200,000 very pissed off insurance agents across the country. You can take about half of that figure and really add to the unemployment roles, their incomes have been cut in more than half. Quite a few I know are now working this part time and have another job. This will be the end of the health insurance agent.

But not everything you read Chrissy is the truth about it, good or bad.

You know mr pp, I don't want you to have herpes or flies. I feel really bad or you. Sincerely from my heart I do.

I'm not sure if you know my full situation with this. Ill make this short. Last year because of ACA the physician fee code schedule for 88305 ( biopsy ) was reduced by 52%, this year the physician fee schedule for the most important test pathology does in order to determine cancer 88342
( immunohistochemistry, basically that's marking tumor cells by using antibodies) by 33%

Ive watched family, friends, and many companies, hospitals be effected from this. closures, lay offs, people being asked to work twice as much with half as much( quality problem). I could go on, but I wont.

In short, I would love for all people to have access to care. and for the most part they have. I'm not as cold hearted as I come across fighting with these people on here. I actually CARE about helping people. I love helping people and I love the healthcare profession.

This clusterfuck of a law is not the solution. and before I get jumped on saying well you have no solution. I may not know the solution, but I know that destroying what we have is not a solution. This is more like fuel to the fire.

And with my most warmest sincere well wishes. I do hope you are blessed with some sort of wind fall for employment or something to sustain you. because I truly hate to see that this has happened to you.

This was as short as I could make it, sorry lol


20Musical interlude... Empty Re: Musical interlude... 2/21/2014, 11:14 pm

Floridatexan

Floridatexan

Your post didn't show up...but, on the contrary, and to show my appreciation:

21Musical interlude... Empty Re: Musical interlude... 2/21/2014, 11:15 pm

TEOTWAWKI

TEOTWAWKI

22Musical interlude... Empty Re: Musical interlude... 2/22/2014, 11:04 am

dumpcare



Dot wrote:
ppaca wrote:
Dot wrote:
Floridatexan wrote:I want to thank you, PPACA, for trying to provide a sane assessment of the new healthcare laws.  I haven't applied yet...but will soon.  I hope the changes to the law are beneficial to you...I knew it wasn't going to be a smooth transition...

i

Pay attention. maybe you should send him some cash. this is what he said earlier today. hope youre happy.

ppaca wrote:No you make a lot of assumptions, I was just screwing with and I do know perfectly well that all the group plans in the state of Florida and many other's are being increased this year up into the double digits and yes it's because of obamacare. I have already gotten mine in every way imaginable since Oct 1. I have basically been out of business since Oct 1, yes one here or there, but it is over.

Yea cash will work Chrissy, maybe I can get rid of the flies and herpes.

Yes I said all that, I was just messy with you when you were pissed over your group rates going up. I believe months ago I said rates on groups would be double digit increases and I also have said before unless you have a subsidy the prices for individual are quite high. I have tried to keep an open mind on both sides of this, since I do see some good things about it, but really very few. I do see it helping someone in their late 50's or early 60's using this to bridge a gap until Medicare eligible. I  don't believe it will remain in it's present form in 3 years, regardless of which party wins in the elections.

I know several have said the insurance company's are in bed with obama, if they are they are they have been in collusion also to get rid of the agent. That I firmly believe. You don't see many advertisements, Call an Agent and he/she will help you enroll, in fact other than a few print materials one company has sent out I haven't seen any. The govt is pushing unlicensed navigator's who can't even spell insurance and the insurance company's have not fought this one bit.

I argue both sides sometime's, but one thing for certain this has created about 200,000 very pissed off insurance agents across the country. You can take about half of that figure and really add to the unemployment roles, their incomes have been cut in more than half. Quite a few I know are now working this part time and have another job. This will be the end of the health insurance agent.

But not everything you read Chrissy is the truth about it, good or bad.

You know mr pp, I don't want you to have herpes or flies. I feel really bad or you. Sincerely from my heart I do.

I'm not sure if you know my full situation with this. Ill make this short. Last year because of ACA the physician fee code schedule for 88305 ( biopsy ) was reduced by 52%, this year the physician fee schedule for the most important test pathology does in order to determine cancer 88342
( immunohistochemistry, basically that's marking tumor cells by using antibodies) by 33%

Ive watched family, friends, and many companies, hospitals be effected from this. closures, lay offs, people being asked to work twice as much with half as much( quality problem). I could go on, but I wont.

In short, I would love for all people to have access to care. and for the most part they have. I'm not as cold hearted as I come across fighting with these people on here. I actually CARE about helping people. I love helping people and I love the healthcare profession.

This clusterfuck of a law is not the solution. and before I get jumped on saying well you have no solution. I may not know the solution, but I know that destroying what we have is not a solution. This is more like fuel to the fire.

And with my most warmest sincere well wishes. I do hope you are blessed with some sort of wind fall for employment or something to sustain you. because I truly hate to see that this has happened to you.

This was as short as I could make it, sorry lol



Well thanks Chrissy, yes no one knows how to remedy the situation, especially the government. I want all to be insured, but under this system it will not happen.

I suppose health insurance agents and the medical field have quite a bit in common as far as the cuts. I just found out a few days ago when we are finally paid any commission's we completed on exchange that part of that fee the insurance company has to pay for everyone they put on exchange actually is going to come out of commission's. Well when you already cut something in half and then take from it that certainly does leave a very bitter taste in your mouth. Now I don't know if the company I represent here in Florida is going to do that yet, but on another forum commission's are starting to trickle in and a few agents said their statements had that deduction on theirs.

I don't know of many agents that are for this law in it's present form, on one hand we thought this was a last hurrah (which it is) that would at least bring in thousands of commission's this year (that isn't happening) and on the other we all hated the fact we had to learn it and be certified by the govt to sell it and be real careful what we told prospective clients for liability purposes. I have heard the navigator's cannot be sued, so no sweat off their backs what they say.

I receive all the same mln and CMS updates and invitations to their seminar's you receive now (guess this came a long with certification) so I do know codes changed for procedures and payments lowered and the cost of everyone going to electronic systems. If there just could have been some way to insure the people that are deemed uninsurable because of certain conditions without all these extensions of the law most attorney's can't even agree on, that would have been fine. But they made this whole thing so damn complicated and a tax here and a tax there and a tax that we probably don't even know about yet even Einstein would not be able to comprehend.

I do believe that all these delays on the group side is just a ploy and will never come to pass (might be wrong) and both sides in D.C. will agree in the next few years Medicare for all may be the best solution. But if that should happen they just won't do it reasonably, they again will have thousand's of pages no one can understand and taxes here and there again.

Although you and many are dead set against it the Feds could fund any heathcare programs if they take a look at the taxes CO. alone is starting to realize from legalization of marijuana. Let's be real here the people who are gong to indulge are already doing it and the one's who are too young to do it now will anyway whether or not it's legal and regulated. It's just going to happen. The one's that go on to stronger drugs would have anyway, just like alcohol.

Online gambling again tax the hell out of it and make it legal at the federal level and again the one's who are going to become gambling addicts, well let's just say it's in their cards now. Also people are doing it now illegally at offshore gambling sites.

If the govt was smart (which they are not) the very things they try to protect us all from could reap more benefits than they could even imagine.

23Musical interlude... Empty Re: Musical interlude... 2/22/2014, 11:40 am

Guest


Guest

ppaca wrote:
Dot wrote:
ppaca wrote:
Dot wrote:
Floridatexan wrote:I want to thank you, PPACA, for trying to provide a sane assessment of the new healthcare laws.  I haven't applied yet...but will soon.  I hope the changes to the law are beneficial to you...I knew it wasn't going to be a smooth transition...

i

Pay attention. maybe you should send him some cash. this is what he said earlier today. hope youre happy.

ppaca wrote:No you make a lot of assumptions, I was just screwing with and I do know perfectly well that all the group plans in the state of Florida and many other's are being increased this year up into the double digits and yes it's because of obamacare. I have already gotten mine in every way imaginable since Oct 1. I have basically been out of business since Oct 1, yes one here or there, but it is over.

Yea cash will work Chrissy, maybe I can get rid of the flies and herpes.

Yes I said all that, I was just messy with you when you were pissed over your group rates going up. I believe months ago I said rates on groups would be double digit increases and I also have said before unless you have a subsidy the prices for individual are quite high. I have tried to keep an open mind on both sides of this, since I do see some good things about it, but really very few. I do see it helping someone in their late 50's or early 60's using this to bridge a gap until Medicare eligible. I  don't believe it will remain in it's present form in 3 years, regardless of which party wins in the elections.

I know several have said the insurance company's are in bed with obama, if they are they are they have been in collusion also to get rid of the agent. That I firmly believe. You don't see many advertisements, Call an Agent and he/she will help you enroll, in fact other than a few print materials one company has sent out I haven't seen any. The govt is pushing unlicensed navigator's who can't even spell insurance and the insurance company's have not fought this one bit.

I argue both sides sometime's, but one thing for certain this has created about 200,000 very pissed off insurance agents across the country. You can take about half of that figure and really add to the unemployment roles, their incomes have been cut in more than half. Quite a few I know are now working this part time and have another job. This will be the end of the health insurance agent.

But not everything you read Chrissy is the truth about it, good or bad.

You know mr pp, I don't want you to have herpes or flies. I feel really bad or you. Sincerely from my heart I do.

I'm not sure if you know my full situation with this. Ill make this short. Last year because of ACA the physician fee code schedule for 88305 ( biopsy ) was reduced by 52%, this year the physician fee schedule for the most important test pathology does in order to determine cancer 88342
( immunohistochemistry, basically that's marking tumor cells by using antibodies) by 33%

Ive watched family, friends, and many companies, hospitals be effected from this. closures, lay offs, people being asked to work twice as much with half as much( quality problem). I could go on, but I wont.

In short, I would love for all people to have access to care. and for the most part they have. I'm not as cold hearted as I come across fighting with these people on here. I actually CARE about helping people. I love helping people and I love the healthcare profession.

This clusterfuck of a law is not the solution. and before I get jumped on saying well you have no solution. I may not know the solution, but I know that destroying what we have is not a solution. This is more like fuel to the fire.

And with my most warmest sincere well wishes. I do hope you are blessed with some sort of wind fall for employment or something to sustain you. because I truly hate to see that this has happened to you.

This was as short as I could make it, sorry lol



Well thanks Chrissy, yes no one knows how to remedy the situation, especially the government. I want all to be insured, but under this system it will not happen.

I suppose health insurance agents and the medical field have quite a bit in common as far as the cuts. I just found out a few days ago when we are finally paid any commission's we completed on exchange that part of that fee the insurance company has to pay for everyone they put on exchange actually is going to come out of commission's. Well when you already cut something in half and then take from it that certainly does leave a very bitter taste in your mouth. Now I don't know if the company I represent here in Florida is going to do that yet, but on another forum commission's are starting to trickle in and a few agents said their statements had that deduction on theirs.

I don't know of many agents that are for this law in it's present form, on one hand we thought this was a last hurrah (which it is) that would at least bring in thousands of commission's this year (that isn't happening) and on the other we all hated the fact we had to learn it and be certified by the govt to sell it and be real careful what we told prospective clients for liability purposes. I have heard the navigator's cannot be sued, so no sweat off their backs what they say.

I receive all the same mln and CMS updates and invitations to their seminar's  you receive now (guess this came a long with certification) so I do know codes changed for procedures and payments lowered and the cost of everyone going to electronic systems. If there just could have been some way to insure the people that are deemed uninsurable because of certain conditions without all these extensions of the law most attorney's can't even agree on, that would have been fine. But they made this whole thing so damn complicated and a tax here and a tax there and a tax that we probably don't even know about yet even Einstein would not be able to comprehend.

I do believe that all these delays on the group side is just a ploy and will never come to pass (might be wrong) and both sides in D.C. will agree in the next few years Medicare for all may be the best solution. But if that should happen they just won't do it reasonably, they again will have thousand's of pages no one can understand and taxes here and there again.

Although you and many are dead set against it the Feds could fund any heathcare programs if they take a look at the taxes CO. alone is starting to realize from legalization of marijuana. Let's be real here the people who are gong to indulge are already doing it and the one's who are too young to do it now will anyway whether or not it's legal and regulated. It's just going to happen. The one's that go on to stronger drugs would have anyway, just like alcohol.

Online gambling again tax the hell out of it and make it legal at the federal level and again the one's who are going to become gambling addicts, well let's just say it's in their cards now. Also people are doing it now illegally at offshore gambling sites.

If the govt was smart (which they are not) the very things they try to protect us all from could reap more benefits than they could even imagine.

sorry to hear youre taking another hit. I feel ya.

I pretty much agree with your assessment here with one exception. There will never be Medicare for all. We cant even afford Medicaid for all. but if it was going to ever be a system like that it would be Medicaid, not Medicare.

what has happened here and it should be illegal is that the GOV has taken over the healthcare system and the private insurance industry by proxy. Dictating through heavy regulation and threats.

as your funny video demonstrated, this admin thinks its "omnipotent".

as you know when they finish off destroying medicare advantage, and they are by 2015. http://online.wsj.com/news/articles/SB10001424052702303636404579397612995261436?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702303636404579397612995261436.html

That will unleash another 16 million really pissed off voters.

24Musical interlude... Empty Re: Musical interlude... 2/22/2014, 11:50 am

dumpcare



I read that article and then received this from CMS this morning. I first have to think rationally about Medicare Advantage because it was expanded under Bush's Medicare act of 2003 and actually cost 13% more than if they would have left it alone and they have to get the money back somehow, but then since I'm on one of these plans I have to think irrationally and say WTF. The copays will go up but they are still will be lower than the group I was on a couple years ago, the call letter I am going to post at least says or asks that the max out of pockets stay the same. Plus another round of commission cuts, seems like no one wants us around anymore.

CMS NEWS

FOR IMMEDIATE RELEASE Contact: CMS Media Relations
February 21, 2014 (202) 690-6145 | press@cms.hhs.gov


CMS proposes 2015 payment and policy updates for Medicare Health and Drug Plans
Greater quality and value for Medicare beneficiaries and improved payment accuracy

Beneficiaries can get greater protections, value, and care in the Medicare services they receive through the proposed policies released today by the Centers for Medicare & Medicaid Services (CMS). The 2015 Advance Notice and draft Call Letter takes important steps to improve payment accuracy for Medicare Advantage (Part C) for 2015. The proposed changes for 2015 are smaller than those implemented in 2014 – a year in which CMS expects to exceed its 5 percent enrollment growth projection in Medicare Advantage for 2014.

Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment has increased by nearly 33 percent to an all-time high of approximately 15 million beneficiaries. Today, nearly 30 percent of Medicare beneficiaries are enrolled in a Medicare Advantage plan. Furthermore, enrollees are benefiting from greater quality as over half of enrollees are now in plans with 4 or more stars, a significant increase from 37 percent of enrollees in such plans in 2013.

“The Affordable Care Act helps strengthen Medicare Advantage and the Prescription Drug Program by providing improved benefits and keeping costs low for Medicare beneficiaries,” said Jonathan Blum, CMS principal deputy administrator. “We believe that plans will continue their strong participation in the Medicare Advantage program in 2015 and beneficiaries will continue to have a wide array of high quality, high value, low cost options available to them while at the same time we are making certain that plans are providing value to Medicare and taxpayers.”

Proposed guidance in today’s Advance Notice and draft Call Letter increases value and protections for beneficiaries:

Lower Out-of-Pocket Drug Spending: Beneficiaries in the Part D prescription drug coverage gap, or “donut hole,” will benefit from greater savings on prescription drugs. As a result of the Affordable Care Act, in 2015, enrollees with liability in the donut hole will receive coverage and discounts of 55 percent on covered brand name drugs and 35 percent on covered generic drugs, an increase from 52.5 percent and 28 percent, respectively, in 2014. The Affordable Care Act’s Coverage Gap Discount Program has provided discounts to more than 7 million Medicare beneficiaries, an average of $1,200 each.
Improved Notification for Beneficiaries Regarding Changes in Medicare Advantage Plan Networks: The call letter identifies as a best practice greater notification to enrollees regarding any changes to provider networks and indicates CMS’ intention to consider rulemaking that would broaden its authority to limit such changes to certain times during the year.
Greater Protection for Beneficiaries: CMS intends to again use its authority, provided by the health care law, to protect Medicare Advantage enrollees from significant increases in costs or cuts in benefits, and, for the 2015 contract year, proposes reducing the permissible amount of increase in total beneficiary cost to $32 per member per month (down from $34 per member per month for the 2014 contract year). CMS proposes to maintain existing limits on beneficiaries’ out-of-pocket spending, but clarifies existing guidance that enrollees’ dollar contributions towards these limits are transferable when they move to any plan, regardless of plan type, offered by the same organization. CMS also continues to require plans to refine their offerings so that beneficiaries can easily identify the differences between their options.
Improving Access to Preferred Cost-Sharing: CMS may request that Part D plans increase the number of pharmacies offering preferred, or lower, cost sharing as we are concerned that some plans that offer preferred cost sharing do not provide beneficiaries with sufficient access to the lower cost sharing at select network pharmacies. The intent of this policy will be to ensure that beneficiaries are not misled into enrolling in a plan only to discover that they do not have meaningful access to the advertised lower cost sharing.
Improved Coordination of Care: CMS intends to expand plans’ ability to use technologies that enable health care providers to deliver care to beneficiaries in remote locations. The use of remote access technologies as a care delivery option for Medicare Advantage enrollees may improve access to and timeliness of needed care, increase communications between providers and beneficiaries, and enhance care coordination.

Other proposals include those aiming to closely align payments in Medicare Advantage with fee-for-service Medicare (Parts A and B), and to improve payment accuracy:

Preliminary estimate of the combined effect of the Medicare Advantage growth percentage and the fee-for-service growth percentage is estimated to be -1.9 percent. This historically low growth in Medicare per-capita spending is tied, in part, to successful initiatives undertaken to promote value over volume and help curb fraud, waste, and abuse in the Medicare fee-for-service program in recent years.
Continue to implement changes under the Affordable Care Act to reduce overpayments and improve quality, by phasing in alignment of MA benchmarks with Medicare fee-for-service (FFS) costs. Before the Affordable Care Act, Medicare Advantage plans were overpaid by more than 10 percent compared to traditional Medicare, costing the program more than $1,000 per person each year, while quality and health outcomes were similar to those enrolled in traditional Medicare. The changes underway reduce overpayments to Medicare Advantage plans, while incentivizing quality improvements by basing part of Medicare Advantage payment on plan quality performance.
Change in how we estimate the annual trend used to adjust for risk score growth to account for the increasing proportion of baby boomers entering Medicare, who overall tend to be younger and healthier than the general Medicare population.
Continue to adjust for diagnostic coding differences between Medicare Advantage plans and Medicare fee-for-service providers. In compliance with statutory requirements, CMS proposes applying a 5.16 percent adjustment for 2015 to MA plan payments, a 0.25 percentage point increase over 2014.
Continue to calculate risk scores in 2015 using the same methodology in effect in 2014.

The Advance Notice and draft Call Letter may be viewed through: http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/ and selecting “Announcements and Documents.” Comments on the proposed Advance Notice and draft Call Letter are invited from the industry and the public and must be submitted by March 7, 2014. The final 2015 Rate Announcement and Call Letter including the final Medicare Advantage and FFS growth percentage and final benchmarks will be published on Monday, April 7, 2014.

# # #


Now something they don't address that the Medicare commission has been mulling over for two years is (don't want to scare you Bob) is the Plan C,F and G supplements, since they are the top of the line wants either some cuts to them or tax the individual. Remember they are just mulling over.

25Musical interlude... Empty Re: Musical interlude... 2/22/2014, 11:54 am

dumpcare



The only reason premiums have stayed low is because the insurance company's are waiting for the other to make the first move to put a premium on them. Plus most of the company's are expanding the HMO Med Advantage to look very attractive on the outside, especially in southern Florida and Tampa area where they have 0 co pays to family doctor, but what most beneficiary's don't understand is absolutely no coverage out of network and no blue card.

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