Home |  Elder Rights |  Health |  Pension Watch |  Rural Aging |  Armed Conflict |  Aging Watch at the UN  

Mission  |  Contact Us  |  Internships  |  Donate Now!  

  Back to Current Articles

Health: United States 

Archives  2005

Healthcare Coverage     Drugs/Pharmaceuticals     Healthy Living

Trade Unions and Health

HEALTHCARE COVERAGE

Medicare/Medicaid | Private Insurance/Other

Medicare/Medicaid

Medicare Plan Designs May Deter Sick Patients, Analysis Says (December 30, 2005) 
Americans who use "specialty" drugs for diseases such as multiple sclerosis, AIDS and anemia may have to pay thousands of dollars more a year under new Medicare drug plans that begin Jan. 1, according to an analysis by health consulting firm Avalere Health LLC. ``It is a way to ensure some plans attract healthier people,'' said Dan Mendelson, president of Washington-based Avalere. Senior citizens, whose drugs are also very expensive and who may require these "specialty" drugs, find the plans very confusing. As a matter of fact, "these formularies are more stringent than what you see in the private sector," Mendelson adds. 

The Long-Term Care Conundrum (December 19, 2005)
Aging is leading the US government to reconsider the way health care is provided to senior and disabled citizens. Though Medicare covers short-term illnesses of older persons, this editorial says that it does not properly cover long-term care and thus leaves this mission, by default, to Medicaid while Congress is trying to reduce the number of its eligible people. "As long as the federal government avoids tackling the long-term care problem head on, it should at least be leading the effort to create a patchwork of mini-solutions," says the editorialist.

Health and Education Measure Narrowly Approved by House (December 15, 2005)
The US House narrowly passed a sweeping budget bill that cuts several key social welfare programs that impact older Americans. The education and health budget bill is $1.5 billion less than last year's version. Medicaid, low-income heating assistance, Meals on Wheels and Medicare doctors' reimbursement rates were on the chopping block. The Senate still needs to act on the terms of the budget passed through the House, but does not need to do so before the holiday recess. Let your federal legislators know what you think about these cuts. 

AMA Makes New Demand on Medicare Payments (December 7, 2005)
The American Medical Association (AMA) has told Congress to stop reducing Medicare reimbursement rates for doctors. The AMA says its members will oppose any legislation that would tie Medicare reimbursement rates to health care quality unless lawmakers halt the planned 4.4% reduction in doctor's payments. 

Republicans Find They Have to Sell Drug Benefit Plan (December 5, 2005)
The new Medicare prescription drug program is caught in the crossfire of a partisan political debate. Proponents of the plan known as Medicare Part D, many of whom are Republicans, believe that private industry and market forces would better serve seniors by encouraging competition to increase quality and decrease costs. Those critical of the plan would rather see one single plan provided nationally through Medicare that allows the federal government to negotiate lower drug costs. This issue promises to be a political hot potato that both Democrats and Republicans are sure to focus on as each side courts voters in the upcoming election cycle. 

Drugmakers Win Exemption in House Budget-Cutting Bill (November 30, 2005)
Pharmaceutical companies won a questionable victory in the budget negotiations on Capitol Hill.  While lawmakers are struggling to cut billions of dollars from federal social service programs, drug manufacturers managed to secure a provision in the budget bill that exempts mental health drugs from initiatives aimed at curbing Medicaid costs.  Budget provisions encourage Medicaid patients to seek cheaper treatment alternatives if doing so would not adversely impact an individual's health.  However, the pharmaceutical lobby made sure drugs used to treat mental health ailments would not be subject to cost cutting efforts.  This move could cost the federal government an additional $125 million in the next five years, and is projected to costs states substantially more as well.  Drug company executives claim they want to protect patients by guaranteeing access to specific mental health drugs.  But, is this more about profits than patient care?

Agency Uncovers Problems in Drug Discount Program (November 30, 2005)
A recent study released by the non-partisan Government Accountability Office (GAO) reveals that the government's pilot prescription drug discount card program was more confusing and costly than helpful to seniors seeking drugs at a lower price.  The discount card plan was to serve as a precursor to the full-fledged prescription drug coverage plan to be offered by Medicare in 2006.  The GAO says information regarding the discount program was often inaccurate and enrollment in the program was lower than expected due to widespread confusion.  In addition, some private companies approved to offer the cards used Medicare funds to cover drugs that were not allowed by the government program.  The discount card program and the new Medicare Part D drug coverage plan are structured in similar ways, as private companies administer both. Seniors are in trouble if Part D is nearly as costly or confusing as the discount card scheme turned out to be.  

Former Bush Adviser Hubbard Calls Medicare Expansion 'Unwise' (November 29, 2005)
Medicare's new prescription drug benefit does not seem to please or benefit anyone. Democrats and Republicans alike have expressed concern about Medicare Part D. In a recent discussion with former Clinton Labor Secretary Robert Reich, R. Glenn Hubbard, former chairman of President Bush's Council of Economic Advisers, criticized Medicare's prescription drug plan. Hubbard characterized Medicare's expansion as "unwise," as the changes were not accompanied by fiscal reforms within Medicare or the health care sector. Former Secretary Reich said government spending on programs including Medicare could not be sustained in the long term if the Administration makes tax cuts for high income Americans permanent. Republican lawmakers frown upon Medicare Part D as an unnecessary expansion of the federal government, while their Democratic counterparts feel the plan lacks key components that would allow for lower drug prices. All the while, older Americans are overwhelmed by a complex web of private plans and premiums that could leave them paying more and receiving less. 

In Medicare, A $170m Savings For Raytheon (November 28, 2005)
The Raytheon Corporation is one of many American companies that intend to use Medicare's new drug plan to help provide prescription coverage to retirees. The new Medicare law provides $71 billion in federal subsidies to employers over the next eight years in an effort to encourage continued prescription coverage for a company's retirees. However, some groups like Raytheon have decided to pass along the cost burden to Medicare by shifting retiree drug plans to Medicare Part B. Raytheon provides supplemental coverage to fill the "doughnut hole" or gap left in Medicare Part D. Is Medicare Part D creating a way for employers to help provide for their retirees or is it just another cost-saving strategy for business?

Insurers' Tactics in Marketing Drug Plan Draw Complaints (November 27, 2005)
Complaints over sales tactics for the new Medicare drug plan have started to flood the Center for Medicare and Medicaid Services (CMS). Concerned seniors and consumers have reported aggressive behavior, unsolicited door-to-door-sales and demands for personal financial information from representatives selling Medicare services. CMS distributed sales guidelines that allow for independent representatives to promote Medicare products. However, these rules have been hard to enforce as both states and the federal government have jurisdiction over administering Medicare Part D. Will seniors shy away from signing up for Medicare's drug plan to avoid confrontation with aggressive sales teams? 

Medicare Makes Room for Medicine Chest (November 26, 2005)
Prescription drug costs are on the minds of most American seniors. Medicare's new prescription drug plan is complex. This article provides a user-friendly overview of how Part D works, whom it benefits, how much seniors spend on prescriptions and how thoughtful leaders view the program. 

State, Local Officials Face Looming Health-Care Tab (November 23, 2005)
States will be making significant alterations due to new accounting changes that will force each state's government to recognize its long-term obligation to pay their retirees' health benefits. In past years, each government made promises that were not realistic for them to keep. Due to cutbacks in taxes and other issues, most states cannot afford to provide their retirees the benefits they are promised. Some of these changes will include, setting aside money annually, cutting health benefits, borrowing money, diverting tax dollars, etc. Because of these changes, there is still a lot of debate and disagreement within each state's government. For the first time the governments will have to announce publicly how much it would cost them each year to provide these benefits. The states will soon have to decide upon a compromise keeping in mind that the accounting changes will take effect starting July 1, 2007.

Drug Costs Run Free Under New York Medicaid (November 23, 2005)
The pharmaceutical lobby is not just hard at work in Washington. It has also turned its efforts to state legislators in New York to persuade them into upholding Medicaid regulations that benefit big drug companies and retailers. New York spends more than most other states to cover prescriptions for Medicaid recipients because the state has not implemented effective cost control measures. New York has typically paid for pricier brand name drugs and provided higher reimbursement fees to those who dispense prescriptions to those on Medicaid, two provisions that are supported by the pharmaceutical industry. Recently New York joined states such as Michigan and California by introducing a list of drugs that Medicaid will pay for. However, the list can be circumvented by a doctor. Medicaid may need to be more efficient in administering its drug provision, but does that mean low-income seniors lose out? 

Aging Boomers Contribute to the Enormous Growth of the Home Healthcare Products Industry (November 23, 2005) 
With a large, rapidly aging segment of the US population, home healthcare is becoming an alternative to nursing homes' rise in cost. In the past few years, not only have many home medical supplies become readily available at the consumer level, but prices have become quite competitive as well. While two years ago, people of 65 years old had 43% chance of spending some time in a nursing home, now the statistic is shifting. 

Vexing Rollout of Drug Plan (November 16, 2005) 
November 15 marked the first day American seniors could sign up for Medicare's new prescription drug plan. But, many are not in a hurry to enroll as the program is seen as confusing and possibly unnecessary for some. 60% of older Americans say they do not understand the plan, while 40% are not sure they will sign up at all. Academic experts suggest that local, state and federal government offices need to increase personnel to better provide individualized counseling about Medicare Part D to seniors. 

Correcting "Medicare Overcare" Could Save $1.7 Billion over Five Years in Los Angeles Area Alone (November 16, 2005)
More care does not necessarily mean better health care, according to a recent study conducted at Dartmouth Medical School. The study evaluated health care systems in major metropolitan areas of California and concluded areas such as Los Angeles could save over $1 billion without reducing quality by implementing more efficient distribution of care. Currently, many hospitals in California have a greater volume of health care choices available. However, there does not seem to be a correlation between increased options and improved health care. Cost cutting reforms could include further restrictions on admitting patients to hospitals. 

Eight Consumer Groups File Lawsuit on Behalf of Dual Eligibles (November 15, 2005)
Several advocacy organizations joined together to file a lawsuit against the US Secretary of Health and Human Services (HHS), Mike Leavitt. The defendants, including the Medicare Rights Center and the Coalition of Voluntary Mental Health Agencies, claim HHS has not done enough to guarantee prescription drug coverage for those who qualify for both Medicare and Medicaid known as dual eligables. There is great concern that thousands of "duals" will fall through the cracks during transition between current Medicaid coverage and the new Medicare plan to cover prescription drug costs. 

Raising the Medicare Eligibility Age with a Buy-In Option (November 14, 2005)
A recent Urban Institute study concludes that a Medicare buy in program, combined with increasing the Medicare eligibility age from 65 to 67, could increase the number of near elderly with health coverage and encourage an older workforce while creating cost savings for the Medicare program. The age for Social Security eligibility is already scheduled to gradually increase from 65 to 67. 

Long-Term Care: Understanding Medicaid's Role for the Elderly and Disabled (November 11, 2005)
Medicaid is the primary resource, especially for low and moderate-income seniors, to pay for long-term care in the United States. Many Americans continue to face the financial challenges associated with taking care of loved ones with chronic illnesses or disabilities. A recent study released by the Kaiser Family Foundation (KFF) suggests that Medicaid spending has increased for in-home and community based long-term care. In addition, the quality of Medicaid programs and resources dedicated to long-term care programs tend to vary from state to state. The Medicaid system needs to be reassessed to assure its continued ability to deliver equitable and cost effective services to those in need. 

Medicaid's Role in Long-Term Care and Track Trends (November 11, 2005)
The Kaiser Family Foundation recently released a series of in-depth reports on long term care coverage and Medicaid. These papers provide detailed analysis of Medicaid's rules pertaining to long term care as well as the complex intricacies of financial requirements for eligibility. It is evident that qualifying for and obtaining long term care is a complex process. 

Older People Divided on Medicare Drug Plan (November 10, 2005)
Most seniors who do not want to sign up for Medicare's new drug plan say they already have coverage. As yet, it is unclear how many eligible individuals will enroll in Part D, a program that is voluntary. A recent survey shows that 37% of seniors see Medicare Part D in an unfavorable light. Another 31% say they do not know enough about the plan to pass judgment. It is possible that as Americans learn more about the new drug plan less will be likely to enroll. 

Vets Lash Out At House Over Budget Moves (November 10, 2005)
American veterans, including many who are seniors, fear the Veteran's Affairs (VA) healthcare budget falls woefully short of the program's financial demands. Earlier this month, the chairman of the House Veteran's Affairs Committee stated veteran's groups are no longer permitted to make legislative recommendations at joint House-Senate hearings. There is currently a $700 million difference between the House and Senate versions of the VA budget. Vets insist that anything short of the Senate's higher budget recommendation abandons the healthcare needs of American military service people. 

Informed Choice Act Puts Seniors First (November 9, 2005)
As open enrollment season starts for Medicare's new prescription drug program, Senators Bill Nelson (D-FL) and Patty Murray (D-WA) want to extend the sign up period through the end of 2006. Nelson and Murray are co-sponsors of the Medicare Informed Choice Act, a bill that would not only extend the enrollment period, but also delay late fees. This legislation allows seniors to change their prescription drug plan once at any time during 2006. The Medicare Informed Choice Act intends to protect consumers in light of the confusing enrollment process and overwhelming number of providers.

Postal Service Asks Medicare to Deliver the Drug Subsidy (November 9, 2005)
The US Postal Service (USPS) applied for the federal subsidy to provide prescription drug coverage to retirees. The Postal Service estimates it will spend roughly 10%, or $7 billion, of its operational budget to pay for employee and retiree health care benefits. Public and private employers can receive a federal subsidy of up to 28% of a company's drug costs. USPS elected to apply for the subsidy even though it is a government agency because it pays for health care costs from postal revenues. 

Drug Makers Expect Hit from Medicare Drug Plan (November 9, 2005)
Drug manufacturers are playing down the profits potentially gained through Medicare's new prescription drug program. Many big pharmaceutical companies worry that the government will try to impose cost controls on the program that is estimated to increase dramatically over the next decade. Cost control benefit consumers and taxpayers who are subsidizing the prescription drug plan. But, it could mean less revenue for big drug companies. The pharmaceutical industry is also wary over mounting pressure to provide rebates to keep prices competitive. Big drug companies see such cost saving provisions as detrimental to their bottom line. What about seniors who cannot afford to fill their prescriptions? Are high prices detrimental to their health? 

AMA Attacks New Medicare Program On Quality (November 9, 2005)
The American Medical Association is critical of a new proposal that would urge doctors to evaluate patient care and effectiveness for Medicare recipients. Because this evaluation program would be voluntary, doctors believe the Center for Medicare and Medicaid Services (CMS) could end up with a shortage of participants. Medical professionals are disappointed in the low reimbursement rate received to treat patients on Medicare. Doctors fear that the government could link reimbursement rates to the effectiveness study and erode payments further. Seniors and doctors should ask what criteria are used to determine health care quality and who sets the rules for the medical community. 

Insurers Sweeten Health Plans for Seniors (November 8, 2005)
The debate continues over Medicare Advantage (MA) programs. Once again, seniors stand to lose out to big insurance corporations that expand their market share at the expense of Medicare recipients. MA plans provide health care coverage to Medicare beneficiaries through private plans such as HMO's. The Medicare Modernization Act of 2003 (MMA) created federal subsidies to such providers as incentives to MA programs to attract Medicare patients. Over time, the goal of MMA is to convert the current fee for service Medicare program administered by the government into a plan serviced by private insurers and hospital groups. MMA increases health care access to rural residents through MA plans at a higher cost. Some suggest MA coverage will reduce costs for seniors, but plans vary widely in cost and coverage. 


Another Choice for Elderly: Charity or Medicare? (November 7, 2005)
Medicare's new prescription drug plan is once again proving it hurt seniors more than it helps them. Several pharmaceutical companies are now forced to change or eliminate their charity drug programs that assist low-income seniors. Once the new drug law comes into effect in 2006, drug companies are prohibited from providing Medicare beneficiaries with anything of value, including reduced cost or free prescription drugs. This change hurts many low-income seniors who have heavily relied on such programs to receive needed drugs. 

Local Clinic May Drop Medicare Patients (November 3, 2005)
Seniors in some states are left in the cold as doctors decide to turn away new Medicare patients due to low reimbursement rates.  New Medicare regulations reduce doctor reimbursements to provide care to Medicare beneficiaries.  These cuts contribute to paying large subsidies to private Medicare Advantage providers that cover less than 20% of American seniors.  Now, many Medicare recipients need to find alternative insurance so they are able to see a local doctor who no longer accepts Medicare patients.  This means more cost and less choice for seniors as well as reduced payments to doctors for quality care. Seniors and doctors lose out. 

CMS Announces Payment Update and Policy Changes for Medicare Physician Fee Schedule (November 3, 2005)
The Center for Medicare and Medicaid Services (CMS) rules are detrimental for doctors and ultimately seniors, while providing a few positive advances for coverage of specific medical conditions. The agency, which updates its policies regularly, emphasized cost competitiveness in its determinations. CMS calls for a reduction of doctor reimbursements for Medicare patients. Doctors across the country can expect to receive $57.6 billion in reimbursements throughout 2006. This amounts to over 4% in cuts to doctors who receive payments from the government to treat patients on Medicare. CMS says the reductions are calculated by a formula that takes increased demand and cost into account. Government officials say it is now necessary to slash doctor reimbursements due to soaring medical costs and a growing population of Medicare beneficiaries. The budget bill pending on Capitol Hill provides a temporary increase to doctor's fees, but it is uncertain if the provision will remain in the legislation's final version. The new CMS rules have a handful of positive provisions to expand coverage for seniors with glaucoma and respiratory diseases. While the new CMS rules reduce doctor payments, it expands payments made to private Medicare Advantage providers. CMS regulations will likely result in poorer quality of care provided by doctors who are underpaid. 

Congress Is Warned of Veto if Insurance Funding Is Cut (November 2, 2005) The White House threatened to veto the pending budget bill if Medicare subsidies to managed care providers, such as HMO's, were reduced. The Senate budget plan eliminates $10 billion in incentives for managed care to attract Medicare beneficiaries. The Bush Administration claims encouraging managed care to cover Medicare recipients will increase health care choice and quality for seniors. However, some Senators believe managed care subsidies use tax dollars to increase HMO revenue, not to augment health care for seniors. 

New Provider of Rides for Medicaid Sparks Concerns (November 1, 2005)
A new company called LogistiCare is taking over coordination of Medicaid-sponsored rides to medical appointments for elderly and disabled people in the St. Louis area. Opponents say that large fines for late drivers will make car companies reluctant to sign up to provide rides. LogistiCare is confident that it will be ready to provide rides. A new co-payment of $3 per ride for Medicaid customers may also cause problems for low-income patients who need crucial medical treatment several times a week. The changes have been introduced in an effort to reduce the cost of Medicaid and are expected to save the government about $15 million a year. But what about the cost to poor elderly?

The Impact of Enrollment in the Medicare Prescription Drug Benefit on Premiums (November 2005)
Medicare Part D premium costs are closely linked to rates of program participation. The Kaiser Family Foundation (KFF) commissioned a study by Avalere Health LLC to analyze the relationship between premium costs and participation of Medicare beneficiaries in the new voluntary drug coverage plan. The study concludes that if few people decided to sign up for Medicare Part D and participants have higher drug bills on average, premiums will be much higher in 2007 than the projected $32 average for 2006. KFF sites the importance of soliciting increased participation, especially from beneficiaries who fall in the non low-income category, those who tend to be healthier and those who use fewer prescriptions. The report concludes with some suggestions for policy reform to attract more participants such as waiving the late enrollment penalty. Without high enrollment or policy changes, seniors can expect to spend more on drug premiums in the years to come. 

Humana Plans: To Capture Large Medicare Drug Market Share (October 31, 2005)
Humana's Chief Executive Michael McCallister says, "[our company's] Medicare strategy is playing out exactly as designed." This means big profits from Humana thanks to the new Medicare prescription drug program. The insurance company offers the lowest premiums in the crowded market of Medicare Part D insurance providers. With premiums priced lower than $20 per month, Humana holds a distinct advantage to attract low-income individuals currently on Medicaid or in need of financial assistance to pay for their prescriptions. Humana plans to hook consumers with the low cost drug plan and then market their full line of Medicare services to their new clients. Humana offers the Medicare Advantage program to cover traditional Medicare services through HMO's. This is just another example of Medicare reform resulting in high profits for insurance companies, and a desire to shift more Medicare patients into private HMO's. 

Lost in the Medicare Maze (October 28. 2005)
Gilbert Cranberg, a senior and former editor at the Des Monies Register in Iowa, sounds off on the pitfalls of Medicare reform. Cranberg says the Medicare prescription drug plan is confusing and skewed against the interest of consumers. He also warns that the Medicare Modernization Act (MMA) aims to privatize Medicare over time by creating incentives to increase the number of seniors signing up for HMO-sponsored Medicare Advantage plans. Seniors can expect increased costs, increased bureaucracy and decreased services in the years to come thanks to MMA. Big insurance companies and HMO's win out while seniors get shortchanged. 

Medicare Drug Bill Holds a Little-Noted Revolution (October 27. 2005)
The Medicare Modernization Act of 2003 (MMA) has spawned the new prescription drug program everyone is talking about. Medicare Part D is expansive and costly. Lawmakers and consumers are concerned the new prescription drug program will become too expensive over time. MMA includes a little-known provision for a program called the Agency for Healthcare Research and Quality (AHRQ) to evaluate the effectiveness and costs of available drug treatments. 

Governors Break NGA Ranks on Medicaid (October 26, 2005)
Governors and Members of Congress have generally dismissed the Medicaid Commission panel as a rubber stamp for White House health care policy. Congressional leaders and governors have passed on the opportunity to serve on the commission until now. Governor Joe Manchin (D-WV) and Governor Jeb Bush (R-FL) broke the united front of the National Governor's Association (NGA) by joining the Medicaid Commission. While lawmakers agree that governors should be part of the Medicaid reform process, few are convinced that anything will be achieved in the most recent round of recommendations. Recently, Florida approved a plan for private health insurance companies to administer Medicaid claims in that state. With the addition of Florida Governor Jeb Bush to the Medicaid panel, can low income seniors across the country expect similar changes to Medicaid in their state? 

State to Pay Feds $40 Million-Plus For Drug Benefit (October 26, 2005) 
States are stuck with the bill to pay prescription drug costs of those who qualify for both Medicare and Medicaid, known as "dual eligibles." Thanks to the Medicare Modernization Act of 2003 (MMA), states are required pay the federal government for providing prescription drug coverage to people who were formally covered by Medicaid. While Medicare is a federal program to provide health care for all Americans over 65, Medicaid is administered by the states and funded jointly between the states and the federal government. The payment from the states, called the "clawback," is determined by the number of dual eligibles and the amount spent on prescription drugs in any given state. Dual eligibles are automatically enrolled in the Medicare drug program if they do not choose one themselves. MMA was meant to save the states money. But, in reality, both states and seniors will end up paying more than expected to fill prescriptions. 

Senate Panel Backs Medicare, Medicaid Cuts (October 26, 2005)
Members of the Senate Finance Committee approved $10 billion in cuts from Medicare and Medicaid over the next ten years. Senators, including Finance Committee Chairman Chuck Grassley (R-IA), claim the budget bill provides and effective compromise to reduce spending while protecting the interests of seniors and low-income Americans. Cuts come from industry subsidies rather than increased costs for beneficiaries. But, the bill falls short to provide necessary aid to the Gulf states devastated by Hurricane Katrina, providing far less than the $9 billion in Medicaid funds originally proposed. 

A Big Insurer Bets on Hot Trend: Shopping Around for Health Care (October 24, 2005)
UnitedHealth is changing the face of health care in the United States by encouraging "consumer driven" health care plans. These systems, meant to force consumers to make more cost conscious decisions about health care, can ultimately lead to delaying needed care to save money. UnitedHealth is a major Medicare provider and continues to expand its network of corporations and services. Doctors are concerned UnitedHealth puts finances before care, which means Medicare recipients could lose out. 

GOP Plan Would OK Medicaid Price Hike (October 24, 2005)
What are some Members of Congress proposing to save the federal government money? Increase Medicaid fees for low income seniors. Members of the House Energy and Commerce Committee want to save the government over $14 billion the next five years by reducing federal expenditures to the state administered Medicaid program. States would now have the right to charge more for Medicaid co-payments. Currently, co- payments cannot exceed 5% of a family's annual income. Government officials argue individuals will make wiser health care choices if they have increased financial responsibility for their treatments. Higher costs may force low income seniors to put off preventive care, and lead to an increase in severe illness. 

Report on Stents Could Spur Increase in Medicare Aid (October 21, 2005)
Stents is a common treatment to open carotid arteries. Approximately 200,000 undergo a stents procedure every year in the United States. Yet, Medicare covers roughly 10% of eligible individuals who need to a stent. However, it is more likely that Medicare will expand coverage for stents, as it appears to be an increasingly simple procedure for doctors to perform. 

How Much Will Enrolling Late In a Medicare Drug Plan Cost? (October 21, 2005)
Seniors who wait to sign up for Medicare's new prescription drug coverage plan could get hit with a much higher late fee than expected. Those eligible for Medicare have a six month open enrollment period to sign up for Medicare Part D. Individuals will be charged a 1% penalty for each month that passes after the open enrollment period ends. Here's the catch: Seniors will generally not have an opportunity to enroll in Part D until the next open enrollment period starts. That means if the May deadline comes and goes, premium payments will be 7% higher for someone who signs up the following enrollment period that starts in November 2006. 

Humana Expands Distribution of its Medicare Products (October 21, 2005)
Big business continues to profit from Medicare reforms. Humana Inc. expanded its network and geographic coverage by partnering with USAA, a financial services corporation based in Texas, and American Insurance Company in Iowa. USAA will offer Humana's Medicare Part D prescription drug plan to its 750,000 eligible members. American Republic Insurance Company will give its 140,000 Medicare eligible members the option to sign up for Humana's Medicare Advantage plans, as well as PPO plans in limited regions. 

States' Fiscal Status and Actions to Slow Medicaid Spending (October 20. 2005) 
A recent report released by the Kaiser Commission on Medicaid and the Uninsured (KCMU) shows states are taking steps to control Medicaid spending. However, many are still concerned about the long-term financial viability of the state-administered health care program for low-income individuals. Most states manage rising Medicaid costs by freezing provider payments and keeping prescription drugs affordable. Growing enrollment and increased health care prices drive up Medicaid spending. For the time being, states have by and large avoided significant premium increases, benefit reductions and eligibility restrictions to manage Medicaid budgets.

Issues in Focus: Medicare's New Prescription Drug Benefit: Part D-Mystified (October 20, 2005)
Global Action on Aging presents an extensive, easy to understand guide to the ins-and-outs of Medicare Part D. The report gives an overview of how the new prescription drug program works, how much it will cost seniors and what factors to consider when choosing a prescription coverage plan. 

Medicaid, Medicare Savings Unveiled (October 20. 2005)
Everyone will lose out if proposed Medicare and Medicaid cuts pass the U.S. House and Senate. Plans to reduce Medicare and Medicaid spending shortchange seniors in need while not providing any real cost savings to the government. Some Senators support a scale back in incentive subsidies to regional insurance companies to provide Medicare Part D coverage. However, spending increases for Medicaid to Hurricane Katrina victims, along with increased doctors payments, far outweigh any savings on proposed budgets that protect senior's interests.

Medicaid Experiment Wins Okay (October 20, 2005)
In a further step toward privatization of federal health programs for poor older persons, the State of Florida has launched a test program to cut Medicaid costs by capping benefits and shifting more patients into managed care plans such as HMO's. Currently, most Medicaid recipients receive fee-for-service treatment in which doctors and health care providers are directly reimbursed for treatment. Under Florida's test plan, Medicaid would now pay set fees to HMO's and doctor groups for each Medicaid patient. This change in Medicaid policy may force some seniors to change doctors as well as limit their care choices. 


Congress Looks at Long-Term Care Insurance Program (October 19, 2005)
Sens. Edward M. Kennedy (D-MA) and Mike DeWine (R-OH) recently introduced bipartisan legislation that could revolutionize long term care coverage for seniors and the disabled. The Community Living Assistance Services and Support Act, or CLASS Act, would enable individuals to allow the federal government to withhold $30 a month in premiums from a person's paycheck. Individuals who become unable to perform two or more daily personal care functions such as bathing, will become eligible for $1500 to $3000 per months in benefits after paying into the system for five years. The benefits would cover in home and long term care assistance. This kind of health care coverage is long over due and, if implemented, will help future generations tackle the rising cost of long term care. If enacted, would it discriminate against low-wage workers who could nor afford $30 per month?


Medicare New Drug Benefit Challenged (October 19, 2005)
The Medicare prescription drug coverage plan is now expected to cost far more than initially estimated. The program price tag is now at $795-billion, up from $395 billion over ten years. Now, some Members of Congress are anxious to delay implementation of the drug coverage for as much as two years due to skyrocketing costs. Postponing the plan could save the federal government $30-$40 billion in one year. As Congress debates the ultimate fate of Medicare prescription coverage, older Americans are currently faced with the tough decision of choosing a drug plan. 

States Protest Contributions to Drug Plan (October 18, 2005)
States will now have to pay the federal government to support the new Medicare Part D prescription drug coverage plan. It was assumed that Medicare reforms would save states money that is spent on individuals who qualify for both Medicare and Medicaid. Now, it seems the states will have to use most of the cost savings to cover the higher-than-expected federal government payments

Drug Companies Programs May Be Better Than Medicare (October 18, 2005)
Drug company discount plans provide more cost savings for some low -income seniors, according to a new study released by the Annals of Internal Medicine. While the new Medicare prescription drug plan saves seniors living at the federal poverty line with a 92% savings, it does not substantially help other low-income individuals. Those with an income above 150% of federal poverty do not qualify for the Medicare low income subsidies, but can save up to 77% of their annual prescription costs through drug company assistance programs. Seniors are urged to examine all options available for the specific drugs they take. 

House GOP Leaders Set to Cut Spending (October 17, 2005)
Congressional leaders announced up to $50 billion in cuts to important programs serving low-income seniors. Medicaid and food stamps are slated to bare the brunt of the budget scale backs scheduled to come before the House and Senate in November. 

Avoid Drug Plan Scams (October 16, 2005)
The government and consumers warn people about marketing scams that they may encounter connected to the Medicare Drug Plan. Actual enrollment starts November 15 and coverage begins on January 1st. The Centers for Medicare and Medicaid Services have asked for help from law-enforcement officials to investigate two possible scams that have asked for patient's bank card numbers and other personal information. Please read the entire article for tips to protect yourself from being a victim. Learn ways to determine if the Medicare Beneficiaries are accredited. 

Medicare And Hospice (October 16, 2005)
It is a little known fact that Medicare provides hospice coverage to the terminally ill who forgo curative treatment. Under this type of plan, Medicare covers a wide variety of services for those at the end stage of life including home health aides and physical therapy as well as prescription drug costs. Medicare costs for hospice care have increased from $1.9 billion a decade ago to $5.9 billion in 2003. Hospice physicians and a patient's primary care doctor must certify that the individual is terminally ill. Once a patient qualifies for hospice care, he or she is enrolled in Medicare hospice coverage for a 90-day period that can be extended for an additional 90 days. If needed, a patient can then apply for ongoing hospice coverage every 60 days. 

Aid Program for Recipients of Medicare Comes to End (October 16, 2005)
Medicare premiums have increased 50% over the last three years. Yet, Congress has allowed the low-income premium assistance program to lapse, leaving thousands of seniors to pay for these costs. This program, known as "Qualified Individual" or "QI" plan allows the federal government to pay for Medicare premiums for individuals making $13,164 to $17,568 a year. If Congress does not act to reinstate the program, the nation's most vulnerable seniors will be stuck with premium costs being deducted from their monthly Social Security check. In some cases, several months of premium costs could be deducted at once. That means hundreds of dollars less a month for low-income seniors who are already struggling to get by. 

GAO - Bush Medicare "Propaganda" (October 16, 2005)
The Government Accountability Office (GAO) ruled the Center for Medicare and Medicaid Services (CMS) violated a government ban on propaganda by producing a questionable promotional video about Medicare. The video contained a segment and accompanying script intended for use by television news outlets. The GAO found it problematic that none of the materials cited CMS or Health and Human Services as the producers of the information. 

Report Says Medicare Easy Target for Fraud (October 12, 2005)
Medicare equipment fraud could be costing you higher premiums and even higher taxes. The Government Accountability Office (GAO) investigators found fraudulent Medicare equipment suppliers were able to reinstate their status to serve the government even after multiple billing and regulatory violations were found. The GAO suggested that Congress implement set waiting periods for suppliers to regain their billing status. Flimsy regulations make it easy to set up fake companies that file false Medicare claims, and ultimately put the patient at risk. 

HMOs in US to Show Medicare Positions (October 12, 2005)
Larger HMO's are expected to profit from the new Medicare prescription drug plan. Providers such as UnitedHealth, Humana, WellPoint and Cigna have invested a considerable amount of resources to expand their Medicare services. These companies currently offer coverage through the private HMO program, Medicare Advantage. HMO groups including Aetna and WellPoint plan to acquire new subsidiaries that will expand their market share further. Analysts speculate that Humana's low cost coverage will attract a sizable portion of the Medicare market. 

Medicare Delays Start of Program to Compare Plans (October 12, 2005)
Medicare delayed the launch of their online prescription drug comparison this week out of respect of the Jewish holiday Yom Kippur. Seniors who visit the medicare.gov help site will be able to enter their prescriptions to analyze the costs of premiums, co-pays, and deductibles as well as consider preferred drug lists. A Medicare spokesperson claims there is no official date to make the comparison tool available, but expects it to be up and running by mid October. 

Grassley Eyes Reconciliation-Bill Gambit for a Ban on Specialty Hospitals (October 12, 2005)
Capitol Hill lawmakers want to place restrictions on specialty hospitals in an effort to prevent manipulation of Medicare billing rules. Senate Finance Committee Chairman, Sen. Chuck Grassley (R-IA), may introduce a provision as part of the pending budget reconciliation legislation that would stop new specialty hospitals from being created. Specialty hospitals focus on a specific area of care rather than offering a variety of services like larger hospitals. Critics believe specialty hospitals can unfairly profit from taking advantage of complex Medicare billing rules. Because doctors own these kinds of hospitals and also practice at large hospitals, there is a possible incentive to refer patients to specialty hospitals for further monetary gain. The Center for Medicare and Medicaid Services (CMS) recently started reforming regulations to tackle specialty hospitals' financial advantages. 

As Deadline Nears, Sorting Out the Medicare Drug Plan (October 11, 2005)
Seniors ask more questions as Medicare Part D information continues to mount. Many may be surprised to learn a Medicare prescription drug plan offered today may not be available for years to come. Under current regulations, a private provider can stop participating in Medicare Part D in 2007, possibly leaving many seniors to repeat the confusing process of choosing a plan. Companies may also change premiums and alter the list of drugs offered subject to federal approval. 

VA Blazes Trail on Drug Prices (October 10, 2005)
The US Department of Veteran's Affairs (VA) developed several cost cutting tactics to save vets money on prescription drugs. Unlike Medicare's drug plan, the VA negotiates directly with drug companies to secure lower prices. The department also conducts "comparative effectiveness" research to determine what is prescribed to whom by looking at the cost and relative effectiveness of different drugs. $15 million was approved by Congress for a similar study by the Department of Health and Human Services (HHS). In some cases, the VA allows pill splitting with a doctor's consent to reduce drug costs for vets. In 2003, the department saved $46.5 million by asking over one million patients to split tablets of the cholesterol drug Zorcor. While studies show cutting the oversized cholesterol-reducing tablets can yield positive results, the VA considers only a small number of pills safe to cut. Ageing advocacy groups and medical professions are unsure about endorsing pill splitting. 

Medicare Help Line Not Much Help (October 10, 2005)
Seniors are frustrated with a Medicare help line that provides little assistance. 89,000 people call the toll free Medicare hotline each day searching for answers about the new prescription drug plan. Unfortunately, many are still left with questions and a lack of understanding about Medicare drug coverage. The Government Accountability Office found 29% of callers received inaccurate information and 10% of calls got no answer at all. 

Medicare Drug Benefit Outlined in Campaign (October 10, 2005)
The US government plans to spend $300 million over the next three years educating seniors about the new Medicare Prescription drug program. Health and Human Services representatives say information will reach seniors through an extensive grassroots network of local community service, religious and non profit organizations throughout the country. The Center for Medicare and Medicaid Services (CMS) is also providing a toll free help line to answer questions from seniors. However, some of the government's educational efforts may be perceived as promotional rather than as a public service announcement.CMS is launching a multi million dollar advertising campaign, with ads in magazines and newspapers as well as commercials on TV. A more personalized approach may be necessary to truly help seniors understand the new prescription drug benefit. 

WellPoint, Walgreen Partner on Drug Plan (October 5, 2005)
Who really benefits from the new Medicare drug coverage program? Stock prices have increased for some companies that have joined forces to provide prescription coverage and sell drugs to Medicare recipients. WellPoint, an insurance provider, and Wallgreen's, a national drug store chain, have partnered to market each other's services and work together to educate the public on the new Medicare drug plan. 

New Medicare Handbook Gives Wrong Info (October 5, 2005)
Medicare Part D has already confused many seniors. To make matters worse, regional versions of the coverage guides have some serious errors that could cost seniors money. It seems that some low-income seniors may not be able to enroll in the plan of their choice after all. Low-income individuals with limited assets may qualify for partial waivers on their premiums or deductibles. However, it is required in most cases to sign up for a policy with a premium at or below the state average to receive assistance. The regional booklets wrongly state that all plans are open to individuals who qualify for the low-income subsidy at no additional charge. Medicare staff caught the error and claim revised accurate information will be posted on their web site. But, will the information be accessible enough to reach seniors who would be impacted? 

How to Choose a Medicare Drug Plan (October 4, 2005)
American seniors should weigh their medical needs, cost and convenient access to drugs when choosing a Medicare Part D provider. There are many choices ranging from cheap, bare bones coverage to costly plans that fill the gap known as the "doughnut hole." What does the "doughnut hole" mean for seniors? Beneficiaries are responsible for paying 25% of drug costs until they spend $2,250 annually. At that point, seniors pick up the tab for the next $3,600 until catastrophic coverage kicks in. Providers then pay 95% of drug costs. 
Cost plays a factor in choosing a provider. Inexpensive plans may suit the needs of seniors who incur minimal drug costs throughout the year. For others who rely heavily on several medications due to ill health, cheap plans may not always be the best value. These plans generally do not address the doughnut hole and typically come with at $250 annual deductible. There are providers that fill the coverage gap for a higher premium. But, generic drugs are usually all that is available. For those who have high drug bills, it is important to consider how patient cost is determined. This is an issue of "co-payment" versus "co-insurance". Under a co-payment, an individual is responsible for a flat fee per prescription. Co-insurance requires patients to pay a percentage of the total cost which could result in higher costs to the consumer. Fees of both kinds are derived from the kind of drugs the patient needs. For example, there may be a different co-payment or co-insurance percentage for generics or highly specified drugs. Some seniors may value convenient access to a local pharmacy. Most prescription drug plans work with a network of specific outlets that provide coverage. Seniors should find out about their plan's pharmacy partnerships before choosing a plan. Several groups offer mail delivery options for prescriptions that could be both a convenience and a cost savings for beneficiaries. Consumers should find out if their specific drugs are on a providers "formulary." The formulary is essentially a list that describes which drugs are considered to be "preferred" on "non-preferred" by a provider. Preferred drugs carry a lower co-pay, whereas a non-preferred drug is usually more expensive. If your specific drug is non-preferred on your plan, you could end up paying more in the long run. 

Medicaid Could Cost Elderly Their Homes (October 4, 2005)
If you are elderly and need Medicaid coverage to help pay for long term care, the government could seize assets after your death to pay for these services. The Medicaid Estate Recovery Program is a federal law that the gives the state the ability to take personal property assets from people signed up for long term care benefits provided by Medicaid. This regulation went into effect in March 2005 and will impact anyone who signs up for long term care after that point. Disadvantaged seniors and the disabled could risk losing their home and property they worked for all of their lives as a cost to aging with dignity. 

Health Care for Katrina Victims (October 4, 2004)
US Senators are blocking a vote on a bill that would help many low-income Hurricane Katrina victims. In September, Senators Charles Grassley (R-IA) and Max Baucus (D-MT) introduced bipartisan legislation that expands Medicaid coverage to the disabled as well as poor adults without children in Katrina effected states for the next five months. This bill also calls for the federal government to pick up 100% of Medicaid costs in Louisiana, Mississippi and Alabama, rather than requiring these states to pay a portion of the program costs as typically mandated. Legislative action has deadlocked on this legislation due to White House opposition. The Bush Administration will reimburse private health providers who cared for Katrina victims, but there is no word on how much would be paid or what services would be covered. 

Scam Alert (October 4, 2005)
Seniors should be wary of scams related to the new Medicare Part D prescription drug program. Telemarketers have targeted seniors, and in some cases, are providing wrong information about Part D. In general, marketing efforts are not focused on helping seniors determine if Part D is right for them. Some seniors then end up enrolling in services they may not actually want or need. Remember, no one can sign up for the new drug benefit before November 15, and current Medicare beneficiaries will not lose existing coverage if they choose not to sign up for Part D. 

Medicare Prescription-Drug Plan Stumps Seniors (October 4, 2005)
A majority of American seniors say they don't understand Medicare's new prescription drug plan. A recent CNN/Gallup/USA Today poll shows 61% of seniors claim they don't fully understand Medicare Part D. Only 37% said they had a limited understanding of the new program. This confusion, caused largely by the vast number of providers and overwhelming amount of information, has caused many seniors to decide against signing up for Part D. Despite efforts to educate the public about Medicare Part D, only one in four seniors polled indicated they would enroll in the prescription plan. 

Medicare Becoming Too Pricey, Critics Say (October 3, 2005)
Older Americans face a vast tax hike in the next year. Medicare premiums will increase by over 13% in 2006. Seniors will have to pay an $88.50 monthly premium to receive outpatient medical services through Medicare Part B. This is a 77% increase since 2001 when premiums were at $50. Those who sign up for the Medicare Part D prescription drug coverage plan will pay on average an additional $32 per month on top of the standard Part B premium. Deductibles are due to increase as well. Part B deductibles will rise from $110 to $124 and seniors will also have to pay a deductible of roughly $250 until the prescription coverage goes into effect. Republican lawmakers say premium and deductible increases translate into a reduction in federal spending of $4.65 billion in one year. But what about the health needs of older Americans?

Foundation Releases Analysis of New Drug Plan for Senior Citizens (October 3, 2005)
The Century Foundation released a new report on the Medicare Modernization Act (MMA) this October. This report provides a comprehensive evaluation of the new prescription drug benefit's ability to provide access to affordable drugs while keeping Medicare program costs low. 

Insurers Start Flood of Ads for Medicare Drug Options (October 1, 2005)
Private insurance companies that provide Medicare Part D coverage are able to market their services to the public as of October 1. Eligible seniors and disabled individuals need to enroll voluntarily in Medicare Part D to receive this prescription drug coverage. Low-income individuals are automatically enrolled if they do not choose a plan themselves. About 30 million of the 43 million Medicare beneficiaries are expected to sign up for Part D. Roughly 12 million Medicare recipients currently have no prescription drug coverage. Some who have coverage through an employer or union are not likely to enroll in Medicare's prescription benefit. Providing Part D coverage is estimated to cost $720 billion over the next decade. 

Eligibility for Medicare Drug Subsidy is Key (October 1, 2005)
Many low-income individuals may qualify for additional prescription drug assistance. Medicare is offering a subsidy to those with low annual income and limited assets. Seniors who think they may qualify should determine if they meet the criteria set by Medicare. 

White House Panel Warns of Aging Crisis (September 29, 2005)
A recent report by a White House commission describes an imminent boom in the population of elderly persons in the U.S. The nation is ill-prepared to care for these persons as the number of qualified health workers is dropping. The government does not address these issues currently. The number of elderly persons is estimated to double by 2050 and the report refers to a looming "large crisis of long-term care." The National Alliance for Caregiving has criticized the report for omitting the impact of the care crisis on family members. The organization says that millions of people could be forced to quit their jobs to care for frail or ill parents.

Reps. Stark, Schakowsky Introduce Legislation That Would Allow Medicare Beneficiaries 6 Months More To Enroll in Drug Benefit Without Penalty (September 27, 2005)
Members of Congress proposed legislation that would extend the Medicare Part D enrollment period by six months and eliminate late fees during that time. In September, Reps. Jan Schakowsky (D-IL) and Pete Stark (D-CA) presented the "Medicare Informed Choice Act of 2005" aimed to give seniors and persons with disabilities more time to wade through the confusing barrage of information about the new Medicare prescription drug plan. 

Giving Part D A Spin (September 27, 2005)
There is an overwhelming amount of information being offered to seniors about Medicare Part D, the new prescription drug coverage plan that goes into effect January 2006. The 40 million Americans who are eligible to sign up for Medicare Part D have a lot of factors to consider when deciding to sign up for this new plan. Many seniors are now weighing their coverage options, as open enrollment for Part D starts this November. There are dozens of providers with varying premiums and drugs offered. Consumers are asking a lot of questions about the true benefit of signing up for Part D coverage, from "Should I stay with my current prescription drug coverage?" to "What happens if I don't sign up for Part D and need it later?" Some seniors are wary to sign up because they are unsure about the value of coverage. Consumers are also cautioned that the cheapest plan may not always be the best savings in the long run. 

We're Extending Our Lives, But at What Price? (September 26, 2005)
Rand Corp. has just released a $2 million federally funded study of future government spending on the elderly. The study's conclusions state that many life-saving medical treatments present great financial risks to Medicare. The researchers found that devices such as pacemakers could cost Medicare and other insurers $1.4 million for every extra year of life they add. Other expensive treatments included drugs to sensitize diabetic patients to insulin and blood-pumping aids. It is estimated that healthcare spending for the elderly will reach approximately $600 billion by 2030. Some have criticized the report for focusing on expensive medical advancements rather than on developments that might cut costs. Another important criticism suggests that focusing on financial issues ignores the value of the lives saved by medical technology.

Medicare Lines Up 9 Insurers for Drug Plan (September 23, 2005)
There are dozens of Medicare Part D providers throughout the United States. Companies offering coverage can vary from state to state. Now, nine insurers have now been approved to provide nationwide coverage. The Center for Medicare and Medicaid Services argues the abundance of choices helps keep costs low. But, many consumers are finding it difficult to choose their plan wisely, as there are so many options available to them. 

Low-Income and Minority Populations Use Medicare Advantage Plans (September 20, 2005)
A recently released Commonwealth Fund study shows 40 percent of African American and 53 percent of Hispanic people without Medicaid or employer coverage rely on Medicare Advantage Plans. The plans are affordable and include benefits not found in Medicare's fee-for-service program. Comparatively, only 33 percent of non-Hispanic, white beneficiaries use Medicare Advantage. The study also found that Medicare Advantage is widely used by low-income populations. While some Democrats and other opponents of the drug bill have suggested cutting funding for the Medicare Advantage program, the study shows that this would disproportionately hurt minority and low-income populations. 

Bush Opposes Delay in Medicare Drug Benefit (September 20, 2005)
The White House has refused to delay the passage of the new Medicare prescription drug benefit in order to offset some of the costs of the hurricane Katrina cleanup. Fiscal conservatives argued that savings from the delay could covering costs of recovering from Katrina. The prescription drug benefit only passed by a slim majority and has come under attack for being an expensive plan. However, the White House seems adamant to implement the plan. Other targets for funding cuts in the wake of hurricane Katrina may include funding for federal highway construction and repair.

Gov't Raises Medicare Premiums Again (September 16, 2005)
Senior citizens and the disabled will have to endure a 13.2 percent increase in Medicare premiums next year. The increase will take the monthly Medicare bill to $88.50, which provides coverage for services and doctor's visits. The government has tried to distract attention from the bite of the increases by focusing on the prescription drug benefit that will cover almost all costs of prescription drugs for low-income Americans. Why can't the US have a national public health program for all persons, such as the Europeans (and Canada) enjoy, that produces quality health at lower cost?

Survey Finds Many Katrina Evacuees had Chronic Health Problems and No Health Insurance (September 16, 2005)
The Washington Post, the Kaiser Family Foundation, and the Harvard School of Public Health have conducted a survey of Katrina evacuees in shelters in Houston. Over half (52%) of those surveyed were not covered by health insurance at the time of the hurricane. 34% of those with health insurance are covered by Medicaid and 16% through Medicare. 33% of interviewees experienced injuries or health problems in the hurricane and its aftermath. Of these, 78% are receiving medical attention for these problems. Some are having difficulties accessing the prescription drugs they need. Many of those interviewed did not evacuate because they were suffering from health problems and were physically unable to leave. As many as 39% stated that they did not receive assistance from any government or voluntary agency during the disaster.

The Kaiser Family Foundation: Medicare Q&A Weekly Column (September 15, 2005)
The Kaiser Family Foundation generates a weekly Question and Answer column that outlines the basics of the new Medicare prescription drug benefit. This week's column explains the changes that will be introduced in January 2006 that will help cover the costs of medication for those who pay a monthly premium for their enrollment in a new prescription drug plan.

Panel Hears Ideas to Cut Medicaid Spending (September 14, 2005)
A panel of Republican legislators in Virginia gathered in mid-September to discuss the options for reducing the state's Medicaid spending linked to individual responsibility, disease management programs and pay-for-performance incentives for providers. The chairman of the Medicaid Reform Task Force, Phillip A. Hamilton said that the Task Force is looking at restrictions on asset transfers by the elderly to qualify for Medicaid to cover nursing-home costs. Long-term care and the idea of health savings accounts for Medicaid recipients will also be discussed.

Kaiser Commission on Medicaid and the Uninsured: Addressing the Health Care Impact of Hurricane Katrina (September 2005)
This Henry J. Kaiser Family Foundation report outlines the health care needs in the wake of Hurricane Katrina. Many facilities providing primary care, emergency treatment, medications, hospital and long-term care, and mental health care have been destroyed or diminished. The vulnerability of elderly, sick, disabled or impoverished groups has increased due to their relocation. The report discusses the implications for health care in the states affected by the hurricane, as well as in the states that host evacuated victims. The report also makes policy recommendations for an adequate government response.

Prevalence of Cataract Causing Vision Problems Appears High Among US Hispanics (September 12, 2005)
A study in the US has shown that older Hispanic individuals have a higher prevalence of visually impairing cataracts relative to African Americans or whites. The researchers found that even after adjusting for high rates of diabetes mellitus, Hispanics are still at a greater risk. Cataract operations minimize vision impairment, however many Hispanics with cataracts are not undergoing the operations. Language barriers as well as lack of health insurance create problems for Hispanics in accessing the care they need.

Medicaid Cuts Could Target Drug Costs (September 12, 2005)
Congress is aiming to reach a decision by October 1 on the best way to implement the proposed $10 billion cuts to the Medicaid program. One of the leading plans involves states negotiating with the pharmaceutical industry for better deals on the drugs they buy for Medicaid patients. The pharmaceutical industry, that would shoulder almost half of the $10 billion under this plan, has warned that this could hurt "some of the sickest, most vulnerable patients," as it could make drugs scarce. Other proposals are not predicted to save the government as much money. Among these is a plan that aims to charge Medicaid recipients higher co-payments for their prescription drugs. Another plan targets elderly people who give assets away before applying to Medicaid. A current plan already penalizes these elderly people, but a proposed change would further reduce their entitlements to Medicaid. This penalty has the potential to hurt elderly people who have simply helped members of their family or given money to charity.

The Poor's PR Problem (September 8, 2005)
Hurricane Katrina has left thousands of poor, sick and elderly people displaced, causing Congress to delay proposed cuts to Medicaid. The $10 billion cuts were due on September 16, but Congress has delayed them only two weeks. Although it is true that these people need Medicaid now more than ever, when the two weeks are over and the television cameras disperse, their needs will not magically disappear. The Hurricane has highlighted the plight of many poor and elderly persons who rely on Medicaid. Will their needs be overlooked once their two weeks are over? Why does Congress think it's okay to cut health care funding for America's poorest citizens? 

Be Prepared, Government Funding for Nursing Homes May Be Cut (September 7, 2005)
In order to cut the budget for Medicaid, the Bush administration proposes slashing Medicaid funds by at least $10 billion within the next couple years. Now Medicaid alone pays almost half of the country's long-term care bills. In the future Medicaid will no longer be an available option for the middle and upper class people. Such persons might purchase a separate long-term care insurance program like the Partnership for Long-Term Care. Having another insurance program will benefit the government because then they would only have to pay for the half of the patient's bills. The government is planning to regulate the rules of people's asset transfers; especially the amount of time that needs to elapse between asset transfer and Medicaid eligibility. Bush wants to cut $1.5 billion over the next five years. What will happen to all the older persons who can't afford a nursing home? Die earlier?

The Medicare Gold Rush (August 30, 2005)
Global Action on Aging predicted that the Medicare Prescription Drug benefit would help health insurance and drug companies and their shareholders far more than sick, older persons who needed medications.  Now the proof is in.  These industries can't lose:  The new law protects high drug prices with government sanctions against importing less costly drugs from Canada or other countries. Moreover, the US government has prohibited negotiations for lower prices from the manufacturers.Wonder why it's considered a "gold rush"? 

Why Blacks Less Likely To Have Chemo Still Unclear (August 24, 2005)
Researchers know that black patients are much less likely than white patients to receive recommended chemotherapy after surgery for advanced colon cancer. They are still confused however, as to why this is so. As an approach of understanding this great inequality, University of Washington doctors looked at the cases of 5,294 elderly black and white patients 66 years of age or older who had surgery for advanced colon cancer. The patients were all covered under Medicare health insurance, yet trends clearly displayed that the white patients had access to chemotherapy at a much higher rate than the equally sick, equally insured, black patients. This disparity in care is simply unacceptable. Can Americans really claim to have equal access to services regardless of race, while such gaping variation exists?

Medicare May Spend $60 Billion on Private U.S. Health Plans (August 23, 2005)
As a nation that is constantly disappointed with Medicare services and their commitment to make healthcare accessible, Americans may soon be pleasantly surprised. There have been talks that Medicare is planning to spend roughly 60 billion US dollars in health benefits for seniors over the next decade, according to an analysis in the journal Health Affairs. This is 30 percent more than anticipated by experts. Although unexpected costs may force Medicare to decrease subsidies along the way-the future definitely looks promising.

More Stroke Information Added to NIH Senior Health Website (August 23, 2005)
Incidences of stroke-especially among the older population-are high. For this reason, information regarding stroke symptoms, what puts certain people at risk of getting a stroke, and what to do if you do get a stroke, can never be enough. The latest edition to the senior health Website created by the National Institutes of Health has recently added more information about strokes in order to better ensure the health and safety of the elderly population. There are more than 700,000 a year in the U.S. and almost three-fourths of them occur in senior citizens over age 65.

Video Robots are Helping Doctors Take Care of an Increasing Number of Aging Patients (August 22, 2005)
Physicians all across the US receiving some assistance with their jobs-and not from nurses, medical residents, or other typical hospital personnel. Physicians have recently been aided by the use of machines to make their rounds, monitor intensive-care units, respond to emergency calls and consult with other physicians. Two sides of this issue are currently making waves:  Some believe that the use of technology further depersonalizes already impersonal care, and others assert that technology will only make things easier and faster in hospitals. For more on both sides, refer to this very interesting piece.

Views of Medicare Plan Mixed (August 12, 2005)
The purpose of the new Medicare plan should be to help the elderly. It should be created as an instrument of positive change- a tool to make healthcare better and more accessible to the masses of elderly. However, many seniors regard the new plan with mixed feelings. Some are thrilled with the changes, saying anyone eligible for Medicare can get drug coverage through the federal subsidized health care program. Still, many find fault with the program, saying that they will end up paying more for their medications than before. The new optional plan can either hurt or benefit one's situation, depending on financial circumstances.

Lower Costs Seen for Premium in Medicare Drug Benefit Plan (August 10, 2005)
The Bush administration said Tuesday that the average premium for the new Medicare drug benefit would be $32.20 a month, about $5 less than previously estimated. Officials said that aggressive competition among private insurers had driven premiums below their expectations. Likewise, Medicare officials said, the first-year cost to the government for each beneficiary who signs up will be about 14 percent less than initially estimated: $1,129 a person, rather than $1,310. Since the government will reimburse the pharmaceutical companies for any losses in 2006 and 2007, critics point out that premiums will likely go up radically in 2008.

Health Coaches to Aid Medicare Patients (August 8, 2005)
Medicare users find this important program very inaccessible due to confusion and ignorance that exists between Medicare administrators and the general public. Change, however, may be on the horizon. A new program to be tested in Florida will provide patients with "health coaches," who will counsel them through important medical choices, and help to respond to elders' fear, ambiguity or incomprehension. The program will not be of any cost to participants, nor will it alter the benefits they receive. It's about time this program was made to be more user-friendly.

Old Age in the Technology Age (August 8, 2005)
With the United States' population rapidly aging, electronic devices to monitor seniors' health and well-being at home are a growing new sector. As with most technologies, senior tech devices are likely to start off pricey. Privacy is also a big issue. 

Cut in Doctors' Medicare Payments Proposed (August 1, 2005)
Physicians may begin to refuse to see Medicare patients, leading to a decrease in the number of people accepted to the program. Medicare plans to reduce payments to physicians by 4.3 percent. The work that physicians do-- along with nurses, technicians and everyone else who works to deliver healthcare services--should be recognized as complicated and stressful but also very rewarding and noble work. It makes sense that delivering a high standard of care is costly. Certainly the people who work hard to keep the healthcare system afloat should receive appropriate compensation. This Medicare cut is fueled by the increasing demand for resources in other areas of the system. If all goes as anticipated, this change will affect more the just the doctors themselves. Perhaps CMS should consider the broader health consequences of this action before taking action.

Medicare Announces $20 Million Surprise for Nursing Homes (July 29, 2005)
CMS (Centers for Medicaid and Medicare Services) announced their plan yesterday to increase payments to nursing homes by $20 million in 2006. The increased funding will allow nursing home workers to be better compensated for the work they do, and will support new payment categories that more closely match the kind of services being provided to elderly patrons. Mark B. McClellan, administrator of CMS, "We are confident that the new payment system will be good for both the industry and the Medicare patients it serves," he said. 

Report Shows Americans' Expectations About Long-Term Care Costs and Views on Quality (July 14, 2005)
A Kaiser Foundation survey found that American adults are grossly mistaken concerning the source of their nursing home coverage. Thirty percent of American adults say that in the case of a loved one or family member needing nursing home care, they would expect most of the coverage to come from private insurance. In actuality, Medicare covers the majority of the cost, while private insurance accounts for only a very small amount (roughly 8 per cent). This report also outlined the views, opinions and expectations of the general public on the standard of nursing home care in the country.

The Middle Class Struggles in the Medicaid Maze (July 9, 2005)
Affluence is something that is definitely sought after. But who ever heard of people striving to reach the poverty line? As it turns out, ten of thousands of elderly Americans are working to do just that: to demonstrate a low income in order to meet the criteria to receive Medicare benefits. These benefits were created to assist only the very poor and elderly, but many people who should be able to pay for specific treatments on paper, are finding that they simply cannot. This piece chronicles the trials and tribulations of one son to pay for the care his parents deserve, but do not qualify for- a situation far too familiar for many American seniors.

Five Tips on Extra Help to Pay for the New Medicare Drug Benefit (July 8, 2005)
The world of Medicare is an illusive, surreal and even scary place for many American seniors today. Leaders at the Medicare Rights Centre are working hard to make the system more user-friendly and comprehensive for their patrons. "Even though applying for the low-income subsidy is more complex than it should be, the extra help to pay for the drug benefit is worth it," explained Robert Hayes, president of the Medicare Rights Center. This article offers five useful tips on how to pay for the new Medicare benefits, in a cost-effective manner. It's about time Medicare became more accessible!

More Than One in Four Non-Elderly Women Delay or Forgo Medical Care Due to Costs (July 7, 2005)
A recent Kaiser Foundation report examines the health of women and the preventative care they receive. One in 10 women (12%) care for a sick or aging relative. One in five (20%) non-elderly caregivers are uninsured. Findings demonstrate that many women simply never obtain the care they need, because they believe they cannot afford to pay the costs. Very few women approach their physicians for information on preventative measures such as the effects of smoking, nutrition and physical activity and even fewer on subjects such as reproductive and sexual health. "The growth in health care costs has become a central women's health issue," said Alina Salganicoff, Vice President and Director of Women's Health Policy at the Kaiser Family Foundation.

Bill Would Cover Anti-Anxiety Medications (July 1, 2005)
As legislation exists currently, Medicare does not cover a category of drugs called benzodiazepines (used to counteract symptoms of anxiety).  Mental health experts are now arguing however, that these drugs are sometimes the only ones that really do help certain individuals, and are seeking to have the plan amended. "This glitch in the Medicare law threatens the health of our beneficiaries," said Rep. Benjamin Cardin, D-Md., who is sponsoring the bill to strike the exclusion. Certain experts contend that the inclusion of these drugs under the plan, stating that "benzos" are frequently abused by the general public, or used inappropriately.
GAA hopes that they do what's best to alleviate people's suffering.

Survey: Most Say Medicaid 'Very Important' (June 29, 2005)
The public's attitude toward Medicaid remains positive despite the big impact the program is having on state budgets and lawmakers' frequent calls for reform, an opinion survey released Wednesday shows. Interestingly, Medicaid is more important for most people than the military defense budget. Maybe the public has decided that the time is right to reduce military spending in favor of social programs!

In Effort to Pare Medicaid, Long-Term Care Is Focus (June 27, 2005)
The federal government wants to restrain eligibility conditions to its benefits and above all long term care benefits. Some older persons are accused of faking poverty in order to profit from the health system. They would have exhausted a lifetime of resources or used legal strategies to give their money away. But a Health Policy Institute report found that the notion of "Medicaid millionaires" concerns a small part of the beneficiaries and that Medicaid people who gave gifts of less than $5,000 on average and so had a minimal impact on the program. US citizens might look to Canada for some models. Canadian public nursing homes appear to combine access and quality of life for Canadian elders, including food and language appropriate to the ethnicity of the older person.

House Blocks Federal Coverage of Viagra (June 24, 2005)
The sexual performance medication, Viagra, will not be covered by Medicare or Medicaid insurance the House ruled this past Friday. Individuals opposing the coverage of medications such as Viagra suggest that having taxpayers empty their pockets for such medications is wrong, "We don't force taxpayers to pay for face lifts, weight-loss drugs, hair-growth treatment or vacations, so we should not force them to pay for sexual-performance drugs," Rep. Steve King of Iowa said. "Medicare and Medicaid were established to provide lifesaving medication for the truly needy." Proponents of Viagra coverage insist that the banning of this medication is not fair to the men who need it. Rep. Nancy Johnson of Connecticut argues that men who are law-abiding and in need of the medications, deserve to have them- especially men who have lost sexual function after suffering prostate cancer and other life-threatening conditions. Sexual dysfunction is a medical condition, and perhaps one that is not taken seriously enough by most. Perhaps the Senate will revise this legislation to accommodate patients who are in need of this treatment. Read on for more on the debate.

Ten Things You Need to Know About Medicare's New Prescription Drug Coverage (June 22, 2005)
For the first time, Medicare is offering insurance coverage for prescription drugs. No matter how much income you have, you may be able to save money on medicines. Here are some of the things you need to know to be ready and well-informed on the new Medicare prescription drug benefit. Educate yourself about this new coverage. 

Bush Calls Medicare Drug Benefit 'Good Deal' During Promotion Appearances In Minnesota (June 20, 2005)
During a speaking engagement in Minnesota, Bush called on community and faith-based organizations, among others, to spread the word about the new Medicare drug benefit. Bush must convince seniors and health care providers that the new Medicare drug benefit will work for the good of the people. Although AARP Minnesota supports Bush's plan, there are mixed reviews and plenty of criticism from all sides concerning Bush's Medicare revisions. Skeptics argue that the new drug benefit, which will go into effect January 2006, is complicated to understand and insufficient to support Medicare recipients. Moreover, the new "benefit" guarantees gigantic profits to pharmaceutical companies who will face no bargaining over whatever price they decide to charge! Buyer beware!

Low-Income Seniors Skimp Less on Prescription Drugs With State Help (June 20, 2005) 
Medicare coverage is not enough for US seniors today. A study conducted by Brandeis University confirms what many policy makers have avoided facing: that without additional state assistance, many seniors are forced to skimp on prescription drugs with Medicare alone. Wisconsin and Illinois have implemented a state sponsored drug prescription assistance program called SeniorCare. Since its inception, SeniorCare has reduced the number of seniors that skimp on medication by more than half. Currently, SeniorCare is the gold standard of state sponsored assistance that Medicare would do well to emulate in its forthcoming assistance program called Plan D. 

AMA Considers Backing Moratorium on Drug Ads (June 19, 2005)
Pharmaceutical companies spend $4 billion each year targeting consumers with ads for medications. In Europe, laws prohibit such ads for drugs. Now, a quarter of a million doctors are lobbying the American Medical Association for a moratorium on drug advertising. They believe these ads lead to high consumer demand for brand name medicines that patients do not need and that are more expensive than cheaper generic prescriptions that often work just as well. Drug companies are becoming very concerned about a possible federal moratorium. Companies, such as Bristol-Myers Squibb Co., are imposing their own voluntary limited moratoriums on their drugs. 

FDA Backs Plan to Monitor Drug Safety Through Medicare Program (June 14, 2005)
The Food and Drug Administration on June 13, 2005 endorsed an idea that experts could greatly improve the nation's drug safety system. How? Using information from the forthcoming Medicare prescription benefit beginning January 1st, 2006, to spot problems with new medications. This proposal comes in the wake of several shocking scandals that have weakened the FDA's reputation.

Health Coverage Costs Rise Due to Uninsured, US Study Says (June 8, 2005)
US families with employer-sponsored health insurance will pay an average of $922 in added premiums this year because of costs doctors and hospitals incur in treating patients who don't have insurance. Families USA, released this report on June 8, 2005. When will US citizens march in the streets and highways and say "Public health insurance NOW!"

Cases, Fines Soar In Fraud Probes Of Drug Pricing (June 7, 2005)
Months before a new law kicks in that will dramatically escalate government spending on drugs, state and federal prosecutors are investigating 150 cases that involve alleged pricing fraud by some of the world's largest drug makers and could produce more than $1 billion in criminal fines and civil penalties this year. Can US elders trust the pharmaceutical companies to clean up their act before the new law goes into effect?

Bargain Hunting (June 6, 2005)
The Federal government has approved multi-state purchasing drugs programs for Medicare beneficiaries such as the one adopted for Louisiana, Maryland and West Virginia. But the influence of the pharmaceutical lobby protects the drug companies from "sacrificing" their huge profits. The penny-pinching will not resolve the growing weight of Medicaid beneficiaries for the states as long as the pharmaceutical companies maintain their corrosive influence in Washington.

Gov. Bush Signs Medicaid Reform Bill (June 4, 2005)
Many people who less than happy with the Medicaid system, often cite a lack of a personal approach to dealing with the sick poor and elderly who utilize the program. Very often, they may claim, plans simply are not suited to reflect a patient's unique and individual needs.
Florida Governor Jeb Bush took a giant leap towards rectifying this problem in Florida, through the signing of a bill designed to make the Medicaid program a bit more like private managed care. "Medicaid is a vital safety net for Florida's most vulnerable, and it's time we transformed the program to reflect the needs of patients, rather than the dictates of government," Bush commented. 
This new system of care would result in a shift from the traditional manner of a patient going to a doctor's office or hospital, to the patient dealing directly with a health management organization, or HMO. 
Proponents of the bill suggest that the new system will allow Medicaid to take a turn for the better, keeping the needs of the patients at heart. Critics of the bill are skeptical. State Representative Dan Gelber, D-Miami Beach, who voted against the legislation, said "It could endanger some recipients" and that he "didn't like state health care bureaucrats designing the program without more input from lawmakers on exactly what it must cover."
Whatever the case, GAA knows that something must be done to make Medicaid a more beneficial system for the poor and elderly.

Begins Outreach for Drug Benefit Plan (June 2, 2005)
About 14 million people will soon be provided with the help they need to finance the cost of their medications. Certain individuals in both the elderly and disabled communities may qualify for financial help through a new prescription drug benefit introduced by Medicare. Medicare will be providing substantial assistance with aid to reduce the program's premiums, deductibles and co-payments.

Fact Sheet on Low-Income Assistance Under the Medicare Drug Benefit (June 2005)
Beginning in 2006, 42 million elderly and disabled Medicare beneficiaries will have access to prescription drug coverage through Part D of the Medicare program, including an estimated 14.4 million who will be eligible for low-income subsidies. This fact sheet provides an overview of the drug benefit and the low-income subsidies and explores how such changes will affect participation and eligibility.

Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences (May 27, 2005)
Over the past few years, a number of states have required new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public coverage programs. This brief reviews the key findings from this recent activity, including the impact on enrollment in public coverage programs, access to care, and providers.

The Use of Oregon's Evidence-Based Reviews for Medicaid Pharmacy Policies: Experiences in Four States (May 26, 2005)
This report explores how four state Medicaid programs, Washington, Wyoming, Minnesota, and North Carolina, differ in their use of Oregon's Drug Effectiveness Review Project (DERP) to manage their prescription drug benefit. The DERP's reports provide references on medicines' effectiveness and are used as a tool by health professionals.

Medicare Will Revise Guide to New Benefits for 2006 (May 22, 2005)
For two years, health policy experts have been warning that Medicare beneficiaries may be confused by complexities of the new prescription drug benefit. Now it turns out that Medicare officials were also confused, not just about the drug benefit but also about other options. Didn't we warn them? When will the US get a public universal health care system that serves the people?

FBI Said to Misuse Funds for Health Fraud Cases (May 16, 2005) 
A new General Accounting Office report says that money earmarked by Congress for investigating health care fraud from the Medicare trust fund, appears to have been shifted improperly to other purposes, like fighting terrorism. How can we TRUST them any longer?

Under New Medicare Prescription Drug Plan, Food Stamps May Be Reduced (May 7, 2005) 
Low income elderly people may lose next January some of their food stamps if they sign up for the new Medicare prescription drug benefit, the Bush administration said Saturday. As they will have less to spend on medicines, they could spend more on food and so..stay poor!

A New Deal for Health: How to Cover Everyone and Get Medical Costs under Control (May 5, 2005)
U.S. spending on health care has grown from $246 billion in 1980 to $1.7 trillion today. At the same time, the number of uninsured Americans has increased by 5 million over the past decade. These factors, along with concern over the quality of care, have brought the need for health care reform back into the headlines. A New Deal for Health offers a plan for these much-needed reforms, one that focuses on creating large risk pools while still allowing consumer choice and maintaining high quality care.

Medicaid's Role in Long-Term Care: Q & A (May 2005) 
Financing long-term care for the nearly 10 million Americans who need services and support to assist them in life's daily activities continues to challenge the nation. While Medicaid is the nation's major source of financing for long-term care services, paying for over 40% of total long-term care, its role is not well understood. Misperceptions on who qualifies and what is covered are common. A new question and answer fact sheet about Medicaid's long-term care assistance provides basic information on Medicaid's role for those with long-term care needs.

Health Coverage Dispute Pits Older Retirees Against Younger (April 30, 2005) 
Health coverage for younger retirees, as a bridge to Medicare, could persuade them to take an early retirement so the firms could hire younger, lower paid people, who are supposedly more efficient to replace them. But is it really fair for the older retirees and really efficient in terms of the financial income for the younger ones? A quality public health care program for all US citizens would answer these issues. Will such a dream ever be won in the USA? Europeans have such systems that work well. Why not those who live in the USA?

Congress Passes Budget With Cuts in Medicaid and in Taxes (April 29, 2005) 
A $2.6 trillion budget outline barely approved by Congress will cut projected spending on Medicaid for the poor, lock in tax cuts and, Republicans would like to make us believe, put the country on a path toward lower federal deficits. Now we can hope the Senate will be smarter.

Troubles Foreseen in Medicare's New Rules (April 25, 2005) 
Care could be disrupted for many of the United States' 1.6 million nursing home residents when the new Medicare drug benefit will take effect in January, advocates and doctors say. The federal government acknowledges that many residents will have to switch from medicines that are working well to less expensive or different drugs.

Medicare Advises on Drug Benefit, Targets Low-income Seniors First (April 25, 2005)  
Medicare counselors in Florida are getting ready to deal with a barrage of questions about the new medicare drug benefit. The seven-page prescription drug benefit application will be sent out in the next few weeks.

Medicare Change Will Limit Access to Claim Hearing (April 24, 2005) 
Under new federal rules, Medicare beneficiaries who appeal denials of benefits may find it significantly more difficult for to have those decisions reversed by independent administrative law judges.

Passing the Buck (April 22, 2005) 
Columnist Paul Krugman suggests that much of America's expensive health care system is based on attempting to get someone else to pay the bills, creating a "vast and hugely expensive insurance bureaucracy." He asks why Americans put up with such an expensive and counterproductive health care system.

America's Health Crisis (April 18, 2005) 
Older Americans have a lot of reasons to worry. The Bush administration threatens their Social Security and Medicare, and this "government's giant health care program for the elderly," is also in crisis. And Medicaid, the program for the very poor, is also in big trouble: 44 million are now without health insurance. It seems very clear: Bush is inventing a problem with Social Security to hide the real breakdown in the US health care system.

The Medical Money Pit (April 15, 2005) 
The US has a lot to learn from other countries about good health care systems. Indeed, while the price of US health care is one of the highest, Americans receive less care and are in poorer health than citizens in a lot of countries. Why? Here's the answer: the high salaries of doctors, the high cost of medications, and the administrative costs of a bloated, bureaucratic delivery system.

Public Hearings on Healthcare Across the Nation (April 2005) 
70 hearings in different communities have been organized by The Campaign for a National Health Program NOW on the health care crisis. You could listen to solutions proposed by citizens and  give your views in order to make some proposals to Congress. Look at the schedule to know when the hearing will take place in your community.

CMS Charts New Three-Year Journey Toward Quality Improvement (April 13, 2005)
The new "billion-dollar program," which sets goals for Medicare Quality Improvement Organizations (QIO), is starting in August. Nursing homes, hospitals, and home health care providers are asked to report specific performance measures to QIOs, which help providers retool systems of care. The program aims at reducing the number of bed sores suffered by nursing home patients and helping doctors' offices use electronic medical records and electronic prescribing to improve the delivery of care. Also, preventing and treating depression in nursing homes is another program goal. For the frail elderly, nursing care is very crucial. We much check to learn whether the program truly improves nursing care!

US Says Medicaid Money Was Obtained Improperly (April 12, 2005)
Federal officials contend that  15 states have been "recycling" federal money, rather than using state and local tax revenue to pay their full share of the costs of Medicaid, which provides health insurance to more than 50 million low-income people.

Medicare Drug Benefit to Help Improve Health of Hispanic Elderly (April 4, 2005)
A change is coming for many elderly Americans, especially the growing Hispanic population, who, for the first time, will be eligible for prescription drug coverage and a physical examination under Medicare benefits. By 2050, one of four Americans will be of Hispanic background and for the moment, few of whom have private health insurance or employer health benefits. Since the US government cannot, by law, negotiate on price with the pharmaceutical companies, the public cost may become astounding! Many older persons, particularly racial ethnic minorities living in the US can afford neither health care or prescription drugs. Why make the drug companies so rich?

Doctors Lobbying to Halt Cuts to Medicare Payments (April 3, 2005)
The Bush administration declared that they will cut payments to medical doctors by 4 percent to 5 percent in each of the next six years. Doctors warned that they no longer will be able to treat Medicare's patients because of their increasing expenses, such as malpractice insurance. Who is still in peril? The poor and the elderly.

CMS Unveils Web Site Comparing Hospital Quality (April 1, 2005)
You can check your local hospitals' quality performance! The Centers for Medicare and Medicaid Services introduces quality performance data for "nearly all" the nation's hospitals on its website. About 4,200 hospitals have reported data. You can compare hospitals based on the care they give for heart attacks, heart failure, and pneumonia. Also, the data is available on Medicare's main website or by calling 1-800-Medicare.

Medicare Monthly Premium Rising to $89.20 in 2006 (April 1, 2005)
Medicare payments to physicians jumped 15 percent last year, an unexpectedly large increase that moved Bush administration officials to announce on March 31, 2005, that monthly premiums for America's seniors will rise to $89.20 in 2006, $1.50 more than initially projected. More MRI's, more tests in doctors' offices, and lengthier office visits account for the higher costs, officials say. They also think that these items will prevent longer, most costly, sicknesses. Let's follow the research on this one!

The Public On Prescription Drugs For Seniors (April 2005)
Historically, Medicare has not provided coverage for outpatient prescription drugs. Given the important role prescription drugs play in health care, and the rising costs associated with them, different proposals to add a drug benefit to Medicare have been proposed in the past. The most recent, the Medicare Modernization Act, passed in 2003, created Medicare Part D, an outpatient prescription drug benefit set to go into effect in January 2006. Seniors' views of the new prescription drug benefit are mixed. In April 2005, more seniors still say they have an unfavorable impression (34%) than a favorable impression (21%) of the new prescription drug benefit, but nearly half have a neutral impression or don't know (45%).A majority (77%) of the public supports the ideas of Congress allowing Americans to buy prescription drugs imported from Canada, and allowing the federal government to negotiate with drug companies for lower prices on prescription drugs for people on Medicare. Behind such strong support is the belief that these policies would lower drug costs - nearly eight in ten (79%) adults believe each policy would reduce drugs costs in the U.S. "a lot" or "some." 

Judge Blocks Rule Allowing Companies to Cut Benefits When Retirees Reach Medicare Age (March 31, 2005)
A federal district judge on Wednesday blocked a Bush administration rule that would have allowed employers to reduce or eliminate health benefits for early retirees when they reach age 65 and become eligible for Medicare. The Commission asserted that employers would be more able to provide good health benefits to retirees under 65 in taking (I should say stealing) money from the benefits of the 65 and older. Fortunately, the judge didn't buy it!

Bush Tries to Reassure Seniors (March 30, 2005) 
The President claims that people older than 55 years don't have to worry about their retirement because their benefits won't be touched and young workers will enjoy the new system because they will be able to do what they want with the great gains in their private investment accounts. Most US citizens don't see it that way! 

Medicare Applications Sent to Low-Income Americans (March 29, 2005)
Means testing costs a lot of money-forms, professional oversight, publicity campaigns, at every level. Often it would be simpler -and often cheaper-to make benefits universally available. But universal coverage fails to punish the poor for being poor. The Administration made some progress toward giving some aid to low-income people with health expenses but the application forms can be difficult to complete. A study last year by the Government Accountability Office found that the response rate was less than 1 percent when officials sent letters to low-income Medicare beneficiaries encouraging them to apply for another form of financial assistance. The commissioner of Social Security, Jo Anne B. Barnhart, said that it was "the most comprehensively evaluated form we have ever produced." Let's see if poor older people in the USA get medicines that they need. 

For Immediate Release (March 22, 2005) 
Centers for Medicare & Medicaid Services Administrator Mark B. McClellan, M.D., Ph.D., today announced the hiring of veteran health care specialist Dan Schreiner to be Medicare's first ombudsman, a role created by the Medicare Moderni