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Medicare Takes Aim at Medical Identity Theft: Protecting Seniors From Fraud

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Criminals are increasingly targeting people age 65 or older for personal identity theft. In 2014 alone, there were 2.6 million such incidents among seniors, according to the Department of Justice.

A growing offshoot of identity theft is healthcare fraud, which can result when someone unlawfully uses another person’s Medicare number. Medical identity theft can lead to inaccuracies in medical records, which in turn can result in delayed care, denied services and costly false claims.

That’s why Medicare works with the Department of Justice, taking aim squarely at would-be thieves. In the largest law enforcement action against criminals fraudulently targeting the Medicare, Medicaid and Tricare programs, 412 people around the country, including 115 doctors, nurses and other licensed medical professionals, were charged in 2017 with bilking U.S. taxpayers out of $1.3 billion.

New Medicare Card for 2018. (Video Courtesy of YouTube)

The next big fraud-fighting push is well underway — and its focus is protecting the personal information of senior citizens by removing their Social Security numbers from Medicare cards.

People with Medicare don’t need to take any action to get a new Medicare card. Beginning in April 2018, the Centers for Medicare & Medicaid Services (CMS) will mail out newly designed Medicare cards to the 58 million Americans with Medicare. The cards will have a new number that will be unique for each card recipient. This will help protect personal identity and prevent fraud because identity thieves can’t bill Medicare without a valid Medicare number. To help with a seamless transition to the new cards, providers will be able to use secure lookup tools that will support quick access to the new card numbers when needed.

Healthcare fraud drives up costs for everyone, but healthcare consumers can be an effective first line of defense against fraud. Follow these tips to help protect yourself:

Do

  • Treat your Medicare number like a credit card.
  • When the new card comes in the mail next year, destroy your old card and make sure you bring your new one to your doctors’ appointments.
  • Be suspicious of anyone offering early bird discounts, limited time offers or encouraging you to act now for the best deal. That’s an indicator of potential fraud because Medicare plans are forbidden from offering incentives.
  • Be skeptical of free gifts, free medical services, discount packages or any offer that sounds too good to be true.
  • Only give your Medicare number to doctors, insurers acting on your behalf or trusted people in the community who work with Medicare, like your State Health Insurance Assistance Program (SHIP).
  • Report suspected instances of fraud.
  • Check your Medicare statements to make sure the charges are accurate.

Don’t

  • Don’t share your Medicare number or other personal information with anyone who contacts you by telephone, email or approaches you in person, unless you’ve given them permission in advance. Medicare will never contact you uninvited and request your Medicare number or other personal information.
  • Don’t let anyone borrow or pay to use your Medicare number.
  • Don’t allow anyone, except your doctor or other Medicare providers, to review your medical records or recommend services.
  • Don’t let anyone persuade you to see a doctor for care or services you don’t need.
  • Don’t accept medical supplies from a door-to-door salesman.

Learn more about how you can fight Medicare fraud at Medicare.gov/fraud, or call 1-800-MEDICARE (1-800-633-4227). You can also visit a local SHIP counselor, who can provide free, one-on-one, non-biased Medicare assistance.

With a common sense approach to protecting health information, senior citizens can be effective partners in fighting Medicare fraud.

 

Source: Centers for Medicare & Medicaid Services

@LeNoraMillen       01-19-18

 

 

 

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Two Million Children Could Lose “CHIP” Coverage Next Month

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Phillip Verhoef speaks at a rally Dec. 14, 2017, hosted by University of Chicago medical students to call on Congress to reauthorize funding for the Children’s Health Insurance Program. | Scott Olson/Getty Images

Nearly 2 million children will lose health coverage starting next month if Congress doesn’t renew funding for the Children’s Health Insurance Program (CHIP) by Friday, a new report projects.

Already, state CHIP administrators say, parents are panicking and permanent damage has been done to the program, set up to take care of kids who don’t have health insurance through other programs.

CHIP covers 9 million children across the country. Congress failed to authorize funding in September, and some states have already started warning parents to get their last medical visits in while money lasts.

“Our phones are ringing off the wall,” said Cathy Caldwell, director of the Alabama Bureau of Children’s Health Insurance.

“We have panicked families wondering what in the world they have as options. So it is just very, very stressful here in Alabama,” Caldwell told reporters in a telephone briefing.

The crisis puzzles health policy experts, doctors and politicians, who say CHIP is a universally popular program that’s never been made into a political pawn before.

Earlier Wednesday, Democrats in Congress urged their GOP colleagues who control both the House and Senate to act by Friday. “This is the ultimate bad Christmas carol story,” Rep. Jackie Speier, D-Calif., said at a news conference where politicians held lumps of coal.

CHIP has bipartisan support, but Republicans have been focused on passing a tax reform bill — their first legislative victory for 2017.

“Congress must get CHIP done before they leave for the holidays,” said Joan Alker, executive director of the Georgetown University Research Center, which issued the latest report.

“Families need the peace of mind that their child’s coverage will not disappear as the new year begins.”

The report finds that 20 states will run short of money in the first quarter of 2018.

“There’s no good options here.” “Never before has congress let CHIP funding lapse for this long a period of time,” Alker said.

The continuing resolution that Congress passed earlier this month shifts around $1.24 billion in CHIP funds so that the states running out the fastest get some 2017 money. But that’s at the expense of states that were not running out as quickly.

“In essence, the patch robs Peter to pay Paul,” the report reads.

“The remaining 31 states will see their share of redistribution funds reduced, and thus the timeline by which they will run out of money is accelerated. Despite the additional funds, the 20 ‘winner’ states will only have sufficient funds to operate their programs through January,” it adds.

“All of them will come up short for February.”

Linda Nablo, chief deputy director of Virginia’s Department of Medical Assistance Services, said her state has even less money than she thought just weeks ago.

“There’s no good options here,” Nablo said.

Caldwell said Alabama is already making contingency plans.

If Congress provides funding by Friday, the state will not have to freeze its programs.

“If it happens after Feb. 1, then we’re looking at rebuilding the program,” Caldwell said.

“Even what’s happened so far, I believe, will cause irreparable damage to the CHIP program. It’s already negatively affecting our credibility.”

The last time Alabama froze enrollment into CHIP, some families stayed away for a decade after funding was restored, she said.

“It will take us years and years to overcome it,” Caldwell said. “But by far the worst is what’s going to happen to the children who lose coverage.”

Pediatricians say when kids don’t have health insurance, their parents skip needed medical care.

“For some conditions, that can be deadly,” said Dr. Sam Bartle, a pediatric emergency medicine physician at the Virginia Commonwealth University/VCU Health System and president of the Virginia chapter of the American Academy of Pediatrics.

 

NBC News and the American Academy of Pediatrics contributed to this report.

#LeNora Millen     12-21-17

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Rev. Jesse Jackson discloses Parkinson’s disease diagnosis

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U.S. civil rights leader the Reverend Jesse Jackson disclosed Friday he has Parkinson’s disease, a progressive neurological condition that affects body movement.

In a  letter to supporters, the 76-year-old civil rights icon said family and friends noticed a change in him about three years ago and he could no longer ignore symptoms.

He says the diagnosis isn’t a sign to stop working but a “signal” to make “lifestyle changes” to slow progression of the chronic neurological disorder that causes movement difficulties.

“Recognition of the effects of this disease on me has been painful, and I have been slow to grasp the gravity of it,” he said. “For me, a Parkinson’s diagnosis is not a stop sign but rather a signal that I must make lifestyle changes and dedicate myself to physical therapy in hopes of slowing the disease’s progression.”

Jackson has been a leader of the U.S. civil rights movement since the mid-1960s and was with Martin Luther King when he was assassinated in Memphis, Tennessee, in 1968.

He twice sought the Democratic presidential nomination and has acted as an emissary to secure the release of Americans held abroad.

Parkinson’s disease occurs when certain nerve cells break down and reduce the amount of the chemical, dopamine, that sends signals to the part of the brain that controls movement, according to Webmd.com. But the disease progresses slowly, and treatments can slow it down even more, it said.

Jackson said he planned to advocate to find a cure for the disease, which he said “bested my father,” strikes 60,000 Americans a year and afflicts 7 to 10 million people worldwide. He also said he is writing his memoir.

“I will continue to try to instill hope in the hopeless, expand our democracy to the disenfranchised and free innocent prisoners around the world,” he said.

Read the letter below:

Dear Friends and Supporters,

 On July 17, 1960, I was arrested, along with seven other college students, for advocating for the right to use a public library in my hometown of Greenville, S.C. I remember it like it was yesterday, for that day changed my life forever. From that experience, I lost my fear of being jailed for a righteous cause. I went on to meet Dr. King and dedicate my heart and soul to the fight for justice, equality, and equal access. In the tradition of the Apostle Paul, I have offered myself – my mind, body and soul – as a living sacrifice.

Throughout my career of service, God has kept me in the embrace of his loving arms, and protected me and my family from dangers, seen and unseen. Now in the latter years of my life, at 76 years old, I find it increasingly difficult to perform routine tasks, and getting around is more of a challenge. My family and I began to notice changes about three years ago. For a while, I resisted interrupting my work to visit a doctor. But as my daily physical struggles intensified I could no longer ignore the symptoms, so I acquiesced.

After a battery of tests, my physicians identified the issue as Parkinson’s disease, a disease that bested my father.

Recognition of the effects of this disease on me has been painful, and I have been slow to grasp the gravity of it. For me, a Parkinson’s diagnosis is not a stop sign but rather a signal that I must make lifestyle changes and dedicate myself to physical therapy in hopes of slowing the disease’s progression.

I am far from alone. God continues to give me new opportunities to serve. This diagnosis is personal but it is more than that. It is an opportunity for me to use my voice to help in finding a cure for a disease that afflicts 7 to 10 million worldwide. Some 60,000 Americans are diagnosed with Parkinson’s every year.

I will continue to try to instill hope in the hopeless, expand our democracy to the disenfranchised and free innocent prisoners around the world. I’m also spending some time working on my memoir so I can share with others the lessons I have learned in my life of public service. I steadfastly affirm that I would rather wear out than rust out.

I want to thank my family and friends who continue to care for me and support me. I will need your prayers and graceful understanding as I undertake this new challenge. As we continue in the struggle for human rights, remember that God will see us through, even in our midnight moments.

 

KEEP HOPE ALIVE!

Rev. Jesse L. Jackson, Sr.

 

By LeNora Millen                 11-17-17

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Trump’s Move to End Subsidies for Health Insurers Expected to Drive up Costs for Middle Class

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President Trump discusses an executive order on Thursday of last week to seek ways for employers to offer health insurance. Later, the administration announced halting subsidy payments to insurers. Alex Wong/Getty Images

President Trump’s controversial decision on last Thursday to end subsidy payments to health insurance companies is project to raise premiums for middle-class families, which will cost the federal government billions of dollars.

The White House administration announced it would stop reimbursing insurers for discounts on co-payments and deductibles—which are offered to low-income consumers and required by law. The reimbursements known as cost-sharing reduction payments, or CSRs if halted, will place the lives of millions of Americans who rely on Obamacare at risk.

The subsidies known as cost-sharing reduction payments sent to insurance companies to keep health insurance premiums down for pre-existing conditions and the elderly has sounded the alarm for both Republican and Democratic lawmakers.

Ohio Governor John Kasich—outspoken for his views on health care voiced concerns to the GOP supporting Trump’s decision to end health insurance subsidies that kept premiums down.

“What are they doing? Are they just passing these things and people are praising what the president did because of politics?” Kasich asked, on Sunday’s “Meet the Press.”

“Do they understand the impact this has on families? On people? Read the stories of what these people are saying. What is the purpose of this? I’ve got to say…. this whole issue is about people. It is not about politics. It is not about numbers. It is about people.”

The Republican Governor, a critic of Republicans who want to repeal and replace the Affordable Care Act, remains consistent in his stance on preserving some key aspect of Obamacare while fixing areas that need fixing.

Attempting to analyze Trump’s reasoning for halting the subsidies, Kasich said he couldn’t determine if Trump did so, to harm President Obama’s signature legislative achievement by dismantling his predecessor’s legacy.

“I can’t read people’s minds, but what I can tell you is to cut these payments off—the people are saying, oh, well these are some big bonus to insurance companies,” Kasich said. “No, these were payments to insurance companies to make sure that hard working Americans who don’t make a lot of money can have their copayments taken care of. It’s a subsidy to do that. And what this — what this decision’s leading to are higher prices.”

Insurance companies will continue to offer discounts to low-income customers. When insurers are not reimbursed by the government, the insurance companies make up the cost by charging higher premiums for coverage.

The subsidy cut to dismantle Obamacare speaks to the strategy of the White House to suck the oxygen out of the Affordable Care Act insurance markets. The looming threat to end Obamacare, and the events unfolding on Thursday points to what many critics say is a deliberate campaign to destabilize the insurance markets—reliant upon the subsidies with hopes of forcing Congress to repeal the law.

President Trump uses the “executive pen” to chip away at dismantling Obamacare. Alex Wong/Getty Images

“Ending the CSR payments is another sign that President Trump is doing what he can to undermine the stability of the individual market under the ACA,” wrote Tim Jost, professor emeritus of law at Washington and Lee University who contributes to the Health Affairs blog.

Trump’s decision to end subsidies will more likely affect middle-class families purchasing insurance without financial help from the government. Consumers earning more than 400 percent of the federal poverty level — an individual with income of about $48,000, or a family of four that makes more than $98,400 — will likely see their costs for coverage increase next year by an average of about 20 percent nationwide.

Individuals with lower incomes will not be affected since the Affordable Care Act (ACA), also known as Obamacare, provides government subsidies — in the form of tax credits — that ensure out-of-pocket insurance costs for people with lower incomes remain stable. When premiums rise, the tax credits rise in tandem.

“We now know what ‘Trumpcare’ looks like, and it’s pretty ugly,” Ezekiel Emanuel, an oncologist who chairs the Department of Medical Ethics and Health Policy at the University of Pennsylvania said when speaking about the fall-out from the administration’s announcement.

“The people who are particularly going to hurt are the people who don’t get any subsidies. They just have to buy their own insurance,” Emanuel, one of the architects of the ACA, told Morning Edition on Friday.

According to the Congressional Budget Office the decision to end the $7 billion-a-year cost-sharing payments will likely cost the federal government more, with estimated figures of nearly $200 billion moreover 10 years.

One way to explain the CBO’s projection—the ACA requires that premiums don’t exceed a set percentage of a person’s income. As premiums set by insurance companies rise over time, the government has to boost its tax credits with the goal of the cost to the consumer remaining the same.

According to the Centers for Medicare and Medicaid Services, approximately 85 percent of people opting for Obamacare insurance got a tax credit in 2016.  The cost-sharing payments have been at the center of a political debate over the Affordable Care Act before Trump took office.

Amid the political debate over Obamacare—House Republicans opposed to the health law sued then-President Barack Obama, citing the payments were illegal because Congress hadn’t appropriated money for them. A federal judge ruled in favor of House Republicans, but allowed the administration to continue making the payments during an appeal.

Threatening to cut off the payments on the campaign trial and during his presidency, Trump referred to as a bailout, he repeated that characterization on Twitter last Friday.

The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!

— Donald J. Trump (@realDonaldTrump) October 13, 2017

The White House cited that legal dispute about insurers having concerns about receiving subsidies—when it announced the end of the payments late Thursday in an official statement:

“The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system.”

The administration’s decision to end the cost-sharing payments came just hours after Trump signed an executive order for individuals and small businesses to purchase cheaper health insurance policies through trade groups and professional associations.

Those plans according to some health care analyst would likely have fewer benefits and appeal to healthier, younger people.

The president’s decision to halt subsidies risk splitting the health care market. Individuals with pre-existing conditions, low-incomes, or medical conditions like diabetes would remain in the ACA marketplaces, while healthier, wealthier people would seek coverage elsewhere. The result would be higher costs for people who need health care most.

By LeNora Millen     10-16-17

 

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