And if the job sounds too good to be true, it probably is. Be aware of job scams.

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12. Medicare: Proposed Rule for Payment under the Ambulance Fee Schedule Proposed Rule for Payment under the Ambulance Fee Schedule (AFS) published 5/26/06 (See AFS Regulations and Notices link.) Section 4531 (b) (2) of the Balanced Budget Act (BBA) of 1997 added a new section 1834 (l) to the Social Security Act which mandated the implementation of a national fee schedule for ambulance services furnished as a benefit under Medicare Part B. ...
13. National Arts and Humanities Month I feel blessed to have lived in the Washington, DC area for many years with easy access to some of the best museums, memorials and monuments, art galleries, theaters and concert halls. When I travel to DC today, I still take the opportunity to visit some of these places because the art and history they [...]...
14. Medicare, Online Small Business Training I think it takes an adventurous spirit and a willingness to take risks when it comes to starting your own business. I admire people who have been able to start a successful business. Have you been toying with the idea of starting your own business? Starting a business can be an exciting and challenging endeavor. [...]...
15. Find a Job Visit USA.gov for a variety of resources to help you find a job. You’ll find resume builders, links to federal and state job websites, guidance during job transitions, and more....

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Unfortunately, there are more serious frauds that are no laughing matter.  Have you heard of the term “sweetheart scam ”? It’s a term that refers to a situation where a scammer acts as if they are interested in developing a romantic relationship with you. They spend time with you (generally on online dating sites) and develop an emotional connection; however, their only intention is to take your money. Some signs to watch out for include:

• Quick declarations of love
• Insistence that you move your communication off of the dating site and use personal email
• Requests that you send money to pay for travel or emergency expenses
• Plans to visit you are prevented due to a traumatic event

Younger adults are not the only ones victimized by this type of scam. Seniors are particularly vulnerable to sweetheart scams.  In such cases, the scammer may be trying to get more than fast cash. They may also have long-term hopes of getting access to the senior’s financial assets and maybe even gain power of attorney. Isn’t that horrible?

You can report a sweetheart scam to the Federal Trade Commission for investigation. And if you choose to date online, use the same privacy tips that you would use on other social networking sites.

Do you have other tips to share about how to prevent this type of scam?

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1. Medicare – Love Stinks When It’s a Scam A sad story appeared in my inbox last week. It was an email from a woman, let’s call her Rosemary, who met an attractive and attentive widower, let’s call him Albert, on a popular online dating site. Here’s how the story goes. ...
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15. Medicare, Statement from NIDDK Director Griffin P. Rodgers for National Diabetes Month, World Diabetes Day The National Diabetes Education Program (NDEP), an initiative of the National Institutes of Health and the Centers for Disease Control and Prevention, is pleased to recognize November as National Diabetes Awareness Month and Nov. 14 as World Diabetes Day. This year, NDEP is raising awareness about the importance of preventing type 2 diabetes by focusing [...]...

This past Sunday a wicked thunderstorm tore through the Maryland, DC and Virginia area. There were tornado warnings in some areas and, though I don’t think any funnel clouds were actually spotted, the storm left quite a mess to clean up.

I wasn’t the least bit prepared for it. I had no idea storms were in the forecast. I was busy helping a friend move.

By the time I got back home, I found out my house had been without electricity for eight hours. Traffic lights were out everywhere, creating back-ups while police tried to direct traffic at some of the busiest intersections.

As I stumbled up the stairs by the glow from my cell phone screen, I tried to remember where I’d stashed my flashlight. I knew I had one somewhere, but of course when I found it the batteries were almost dead so the light flickered a lot.

Luckily, my power came back on about a half hour later. Being able to run the fans and the air conditioner helped cool the stuffiness and I was lucky that none of the food in my fridge had gone bad.

Several of my friends and coworkers aren’t expecting to get their power back until the end of the week. They’re getting by on candlelight and flashlights and eating most of their meals at restaurants since all the food in their fridges has gone bad.

It’s a crappy situation all around, but stuff like this always reminds me of the importance of being prepared in an emergency. FEMA has a great list of things to keep on hand, just in case, as well as advice on how to put a disaster kit together.

I know I need to find some new batteries for my flashlight. What’s one thing you need to do to be prepared for the next big storm?

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2. Sales Tax Holidays, Save Your Medicare Benefits It’s almost back to school time, and when you’re a parent, that means it’s back to school shopping time.  I don’t know why, but it always catches me by surprise. I should know better. The kids have grown and they need new clothes, and shoes. Their backpacks are worn to threads so they need new [...]...
3. Pool and Spa Safety: Medicare Help When I was a little kid I can remember my mom warning me not to swim too close to the drains in pools and not to put my head under the water in hot tubs. She was concerned that my ponytail would get caught and I would drown. I always thought that was a little [...]...
4. Medicare – Census 2010 Forms The good news is that it’s easy - when you get your form, just answer the 10 questions and mail the form back in the postage-paid envelope they provide (the form cannot be completed online). It only took me a couple of minutes to complete mine. ...
5. Earthquake in Chile – Is Your Medicare Paid Up While the world is still scrambling to help the people of Haiti in the aftermath of their earthquake- another quake hits Chile. ...
6. Medicare, Medicaid, Medical Information on Attention Deficit Hyperactivity Disorder My nephew was making my sister and her husband crazy. He was fidgety, he couldn't keep his hands to himself, and he was always losing things. His grades weren't very good and his teachers were frustrated because he was constantly distracting other kids. He would do impulsive things that ended up with him breaking things or getting hurt. ...
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8. Medicare Decisions Can Provide Healthier School Lunches The peanut butter and jelly sandwiches served at my high school were epic. Using THREE slices of white bread with peanut butter spread on both the top and bottom, it was like a little slice of heaven at 11:30am. Looking back, it's a marvel that I made it out of there alive....
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11. Medicare Card Help, Preventing Hearing Loss It drives me nuts when I’m sitting on the train and I can hear the music blaring from another person’s iPod. It’s just plain rude to be playing your music so loudly that it disrupts the rest of the train. But even if those people aren’t considerate of others, shouldn’t they at least care about [...]...
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15. Government Closed… Not Really As you all know, the Washington, DC area is under siege with Snowmageddon 2010, and the federal government in the DC area is officially closed...

Airline travel has gotten so complicated.  Security lines are long; there are extra fees for baggage; adults need to keep out their federal or state-issued ID through the checkpoint; and there are restrictions on what can be carried onto the flight.  The Transportation Security Administration’s (TSA) website is the first place to go to find out the truth about these restrictions.

Here are three things you can’t carry on to your flight:

1. Liquids over 3.4 ounces (including toothpaste)
2. Scissors (blades larger than 4 inches)
3. Knives with sharp blades, including pocketknives

Check the full list of prohibited items at the TSA website.

By the way, you can carry-on nail clippers, lighters, medications and knitting needles.

Are you curious about what happens to all the items that don’t make it through the security checkpoint?  Check out Blogger Bob’s answer on the TSA Blog.

If you have questions or comments on your security experience, you can send TSA an email via Talk to TSA.  It will be answered by the person in charge of security at the airport for which you’re commenting.  Happy traveling!

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Arlene Hernandez is the manager of Kids.gov, the government’s official source for kids to find all kinds of government information.

When I was a teenager and hanging out at the mall, I used to see young kids whaling and crying and throwing a fit at the toy store.  I would think “Geez, what’s up with that kid?” and I probably rolled my eyes.

Now that I’m a mother of a 3-year-old, when I see that situation all I think is “Oh that poor parent… I feel your pain.”

The other night, my son had a big meltdown. He refused to put his pajamas on. First it was a whimper, but within a few minutes it was a full-blown tantrum, complete with yelling, tears, stomping and throwing his body on the floor. My husband and I were just looking at each other like “I have no idea what to do… Can someone please call Super Nanny?”

I wish that I would’ve known about the Child Welfare Information Gateway. They have a whole section on dealing with temper tantrums (also available in Spanish). Some tips to remember:

1. Redirect your child’s attention to something else, like a favorite toy or a trip to the library.
2. Remain calm and don’t lose control.
3. Hug or hold your child until the tantrum subsides.
4. Put your child in a quiet place where he or she can calm down.

So for all the parents out there – how do you deal with tantrums? Do time outs work for you? Has anyone tried using positive discipline?  Any suggestions for me and our readers?

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1. Babies on Airplanes – Making Plans to Travel While on Medicare I may be a good friend, but that doesn't mean I'm not bitter. So, because it was 4am, and because I'm not a morning person, and because I'm insanely jealous, as I dropped my pal off I told him I hoped he was seated in-between two teething infants on the flight....
2. Read Across America Day – Teach A Younger Generation How To Avoid Stuck On Medicare? What’s your favorite Dr. Seuss book?...
3. Avoid Sports Injury This Spring – Is This A Medicare Benefit Coverage The start of spring means the start of Spring Training. The major leaguers start warming up for the season, and it's not long before little leaguers follow suit. Tons of kids play on youth baseball and softball teams every year and right about now they are in their spring training....
4. Pool and Spa Safety: Medicare Help When I was a little kid I can remember my mom warning me not to swim too close to the drains in pools and not to put my head under the water in hot tubs. She was concerned that my ponytail would get caught and I would drown. I always thought that was a little [...]...
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6. Medicare Benefits, Swimming and Water Safety When I was growing up I spent most of the summer in some state of wetness. My town had a pool that was easy for us to walk or ride our bikes to and it was the center of summer social activity. I took swimming lessons, I swam on the swim team, I became a [...]...
7. How Do I Become President Challenge When I was younger, my parents told me I could be anything when I grew up, even the President. I think parents still probably tell their kids that same thing today to encourage them to set high goals for themselves. Of course, it also leads kids to wonder how exactly they could become President. On [...]...
8. Weekly Picks 11/27 I hope you all had a great Thanksgiving. I ate so much I still feel as big as one of those Macy’s Thanksgiving Day Parade balloons. With Thanksgiving over, it’s time to get down to the serious business of getting ready for the winter Holidays. Check out our Holiday page. It features links to tips [...]...
9. Encourage Kids to Read Through summer reading, kids may discover a favorite author who sparks a lifelong love of reading. Summer reading can also prevent learning loss and help prepare a child for the next academic year. Find a variety of reading resources on Kids.gov....
10. Back to School and Immunizations It’s mid-August and many families are in the middle of the mad dash to get the kids ready for the coming school year. There are school supplies and clothes to buy, forms to fill out, busing/carpool schedules to arrange, and, if needed, ensuring that after school childcare is in place. Then of course, there is [...]...
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12. Children’s Health Month Children’s Health Month serves as a reminder to parents and caregivers to protect kids from environmental risks. The U.S. Environmental Protection Agency provides a calendar with daily tips that include testing your home for radon, preventing poisonings, and protecting kids from too much sun exposure....
13. It’s Not the Hot Dog’s Fault – Medicare and Eating Healthly They are front and center at summer barbecues. And who hasn't ordered one at a baseball game? Stuffed in a bun, slathered in ketchup, mustard, or whatever topping your prefer, they scream American summertime. But a group of pediatricians wants to fundamentally change the hot dog because they say its shape poses a choking risk to children. Sadly, hot dogs are the cause of 17 percent of asphyxiations in kids under 10....
14. Medicare, Let Your Kids Help in the Kitchen My friend’s 6-year-old daughter wanted to be Bobby Flay one morning and created a new snack: tomato with yogurt and sprinkles. I love the fact that this little girl got an idea in her head and created a brand new snack all on her own. Hey producers of The Next Food Network Star – she [...]...
15. Medicare Card, Annual Federal Statistics Compilation Reports Second Straight Decline In Preterm Births Preterm births and adolescent births declined, eighth graders’ math and reading scores increased, and more children had health insurance, according to the federal government’ annual statistical report on the well-being of the nation’s children and youth. The report also showed several economic changes that coincided with the beginning of the economic downturn: increases in child [...]...

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1. Medicare, Study of MicroRNA, Helps NIH Scientists, Unlock Secrets of Immune Cells With the rapid and continuous advances in biotechnology, scientists are better able to see inside the nucleus of a cell to unlock the secrets of its genetic material. However, what happens outside of the nucleus has, in many ways, remained a mystery. Now, researchers with the National Institutes of Health are closer to understanding how [...]...
2. Medicare Medical Care, Rapid Development of Drug-Resistant, 2009 H1N1 Influenza Reported in Two Cases Two people with compromised immune systems who became ill with 2009 H1N1 influenza developed drug-resistant strains of virus after less than two weeks on therapy, report doctors from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Doctors who treat prolonged influenza infection should be aware that even a short course of antiviral treatment may lead to drug-resistant virus, say the authors, and clinicians should consider this possibility as they develop initial treatment strategies for their patients who have impaired immune function....
3. Medicare, Common Mechanisms of Drug Abuse and Obesity Some of the same brain mechanisms that fuel drug addiction in humans accompany the emergence of compulsive eating behaviors and the development of obesity in animals, according to research funded by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health....
4. MedicareCard.com, Experimental Immune, Boosting Drug Worsens TB in Mice An experimental drug that boosts production of the immune system protein interferon worsens tuberculosis (TB) in mice, according to scientists from the National Institutes of Health. The drug acts indirectly by drawing certain immune cells, in which Mycobacterium tuberculosis (M.tb) bacteria thrive, to the lungs. The findings may have potential implications for the care of people infected with TB, the authors note. The research is reported in the May 3 issue of Journal of Clinical Investigation, now available online....
5. Medicare, After 40 Years, NIH-Supported Researchers Identify Possible New Treatment for Severe Vasculitis Investigators have made a major advance in treating people with a severe form of vasculitis, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, a rare but devastating disease of blood vessels. In a six-month study, a new treatment strategy provided the same benefits as the current standard of care used for more than 40 years but required less [...]...
6. Medicare Card: Gene Linked to Alzheimer’s Disease Plays Key Role in Cell Survival Scientists have discovered that a gene linked to Alzheimer’s disease may play a beneficial role in cell survival by enabling neurons to clear away toxic proteins. A study funded by the National Institute on Aging (NIA), part of the National Institutes of Health, shows the presenilin 1 (PS1) gene is essential to the function of [...]...
7. Medicare Card News: NIH Researchers Explore How Healthy, Young Adults View the Role Genetics Plays in Improving Health Most healthy young adults place greater emphasis on health habits than on genetic risk factors when considering what causes common diseases, a research team from the National Human Genome Research Institute (NHGRI) and the Henry Ford Health System in Detroit has found. The study, based on a survey of 25- to-45-year-olds, was released June 8, [...]...
8. Medicare, Gene Pattern, May Identify Kidney Transplant Recipients, Who Don’t Need Life-long Anti-rejection Drugs Researchers have identified a distinct pattern of gene expression in the largest reported group of kidney transplant recipients who have not rejected the transplant kidneys even though they stopped taking anti-rejection drugs. This finding may help identify other transplant recipients who could safely reduce or end use of immunosuppressive therapy. In 2008, more than 80,000 [...]...
9. Medicare Card, Scientists Identify Markers, Human Breast Cancer Cells, Linked to Development of an Aggressive, But Less Common Form of Breast Cancer Scientists have identified a group of surface markers on cells linked to an aggressive type of breast cancer called estrogen receptor-negative cancer. In this preliminary study, estrogen-negative breast cancer developed when three markers, CD44+, CD49fhi, and CD133hi were present simultaneously on the surface of human cells taken from breast cancer patients and transplanted into a [...]...
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14. Medicare: Does the ADA Restrict Testing for Illegal Drug Use? The ADA specifically permits testing for illegal drug use....
15. Medicare Card: NIH Researchers Identify New Steps in Spread of Malaria Parasite Through Bloodstream Researchers at the National Institutes of Health have observed two previously unknown steps in the spread of the malaria parasite through the bloodstream. And in laboratory cultures, the researchers interfered with one of these steps, raising the possibility that new drug treatments could be developed to combat the disease....

I always thought that was a little morbid. I was just a kid and wanted to have fun.

But my mom had reason to be concerned. The Consumer Product Safety Commission launched the Pool Safely campaign earlier this week in response to the number of injuries and deaths from submersions and entrapments in pools and spas.

The commission released some scary statistics:

From 2005-2007, for children younger than 15, there was an average of 385 drownings in pools and spas each year.

74 percent of those fatalities happened at a home and not in a public pool.

The new campaign will help educate people about the simple steps they can take to make sure their kids stay safe around the water.

Tips include:

• Make sure drain covers meet compliance standards
• Install fences with self-latching gates around pools to keep children from falling in
• Don’t let kids swim unsupervised.
• Learn CPR to be prepared

What tips do you have for keeping you and your kids safe in the pool?

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Or you can get drug coverage and the rest of your Medicare coverage through a Medicare Advantage plan, like an HMO or PPO, that typically provides more benefits at a significantly lower cost through a network of doctors and hospitals. No matter what type of plan you choose, you can choose a plan that reflects what you want in terms of cost, coverage and convenience.

• Cost: What you pay for the coverage, including premiums, deductible, and payments for your drugs.
• Coverage: What benefits are provided (like coverage in the “coverage gap” and other coverage enhancements), which drugs are covered and the rules (like prior authorization) for getting those drugs.
• Convenience: Which pharmacies are part of the plan and whether the plan has a mail-order option.

The Centers for Medicare & Medicaid Services has created an online resource, Landscape of Local Plans . This resource helps you find Medicare prescription drug plans by state or Medicare Advantage plans with prescription drug coverage by county. It lets you see the plans in your area that offer drug coverage, including basic information to help you find ones that meet your needs based on cost, coverage, and convenience.

This is the first week that you can see drug plan data. Some of the features of the Medicare Prescription Drug Plan Finder are not yet available. These features will allow you to further personalize your search for a drug plan that meets your needs. These features will be available well before you can choose to enroll in a plan on November 15.

Right now, it is important to get ready to choose a plan by making a note of the drugs you take, the coverage features most important to you, and any specific pharmacies you prefer to use. The Landscape of Local Plans is a good resource for finding out about the plans in your area to get ready to make a choice.

Reference: http://www.medicare.gov/MedicareReform/drugbenefit.asp

The best individual dental insurance on the internet: http://www.insurancecompany.com

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Many people qualify for these big savings and don’t even know it. To find out if someone is eligible, Social Security will need to know the value of their savings, investments and real estate (other than their home), and their income. If they are married and living with their spouse, we will need this information for both of them.

To qualify for Extra Help, they must:

• Reside in one of the 50 states or the District of Columbia
• Have resources limited to $12,510 for an individual or $25,010 for a married couple living together. Resources include such things as bank accounts, stocks and bonds. We do not count their home and car as resources; and
• Have income limited to $16,245 for an individual or $21,855 for a married couple living together.

Even if their annual income is higher, the ones you care about still may be able to get some help with their monthly premiums, annual deductibles and prescription co-payments. Some examples where income may be higher include if they or their spouse:

—Support other family members who live with them;

—Have earnings from work; or

—Live in Alaska or Hawaii.

Note: Beginning January 1, 2010, more Medicare beneficiaries may qualify for Extra Help because some things no longer count as resources and income. We will no longer count as a resource any life insurance policy; and we will no longer count as income the help they receive regularly from someone else to pay their household expenses—food, mortgage, rent, heating fuel or gas, electricity, water, and property taxes.

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The fax and secure website options should integrate easily with existing work processes. If your records are already electronic, you will be able to upload files directly instead of printing. If your records are on paper, you can use the website by scanning, instead of photocopying your records or you can fax your records. 

Why is the letter with the barcode so important?

The letter with the barcode is important because it helps us link the records or information you send to the applicant’s unique disability folder and make any appropriate payment to you. If you do not include the letter with the barcode as the first page, there may be significant delays associating the information with the applicant’s electronic disability folder and making payment to you.  

How will I know whether my electronic record transmission was successfully received?

When using the secure website, you’ll receive an immediate tracking information page which you can print or store electronically for your records. When sending by fax, your fax machine should indicate a successful transmission including the number of pages that were sent. 

Can I amend my reports?

You may choose to amend your reports by sending new information; however, the original reports you sent will remain part of the electronic file.  

Will this change the amount that I am paid for my reports?

No, the compensation will remain the same. However, you may notice resource savings when you send records electronically to Social Security. 

How will I know the applicant is giving informed consent to have their records sent electronically?

Social Security complies with all laws and regulations regarding release of medical and school records. Form SSA-827, “Authorization to Disclose Information to the Social Security Administration,” which accompanies every request for health and school records from Social Security, contains language that specifically permits electronic processing.  

Are the Electronic Records Express options compliant with the Health Insurance Portability and Accountability Act?

Yes, both the online and fax options comply with the goals of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If used in conjunction with a properly designed and implemented HIPAA plan, these options can add significant value to safeguarding the security of your patient data. 

Are the Electronic Records Express options compliant with the Family Educational Rights and Privacy Act?

Yes, both the online and fax options comply with the goals of the Family Educational Rights and Privacy Act of 1974 (FERPA). These options can add significant value to safeguarding the security of your student data.  

How can I send in evidence when my client’s case is an electronic case? 

You can submit evidence directly to your client’s case file by using your office fax or through the Social Security secure Electronic Records Express website.  Both of these methods require that you use the specific barcode provided for your client by the state Disability Determination Services (DDS) or the Social Security hearing office that is handling your client’s disability claim.  For example, if your client’s case is at the hearing level, you would contact that hearing office to obtain a barcode for your client. 

What hardware or software will I need to use the secure website?

Most common Internet browsers will support the secure website.  If you experience issues or difficulties, call the Social Security Electronic Records Express Help Desk at 1-866-691-3061 or send them an email at electronic-records-express@ssa.gov for assistance.  

Are there costs to use the secure website?

No. The government provides this service free of charge.

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The short-term project consists of two parts: 1) Acquire existing, updated occupational information in a format consistent with the Dictionary of Occupational Titles (DOT), and 2) Obtain the services of an Independent Evaluator who will assess the accuracy and reliability of this occupational information. The goal of the short-term project is to provide SSA with updated occupational information that will be formatted in a manner consistent with the format and definitions found in the Dictionary of Occupational Titles (DOT). This updated occupational information will provide disability adjudicators with updated occupational information that can be seamlessly incorporated into SSA’s disability adjudication process while long-term solutions are developed.

The long term project goal is to develop an occupational information system designed specifically for SSA’s disability process. We will conduct research to obtain and classify current occupational information critical for evaluating disability. We will also conduct investigations to test policy options and to improve SSA’s medical-vocational assessment of disability claimants in light of the new occupational information we obtain. These activities will involve the collaboration of internal SSA components, already convened as the Occupational Information System Development Workgroup, that will provide guidance on policy and operational issues and end-user needs.

One important element to our long-term research is the development of the Occupational Information Development Advisory Panel established under the Federal Advisory Committee Act. The Panel will consist of occupational analysts, vocational rehabilitation experts and other relevant professionals and medical practitioners who will guide and oversee SSA’s long-term research efforts, including recommendations at each stage of research and investigation.  For additional information on this effort, please visit www.ssa.gov/oidap.

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Section 1834 (l) also requires mandatory assignment for all ambulance services. Ambulance providers and suppliers must accept the Medicare allowed charge as payment in full and not bill or collect from the beneficiary any amount other than any unmet Part B deductible and the Part B coinsurance amounts.

A cover sheet is provided with every year’s PUF giving detailed information concerning the amounts payable and any special circumstances pertinent for that year’s payments.

NATIONAL BREAKOUT OF GEOGRAPHIC AREA DEFINITIONS BY ZIP CODE

In response to several requests from the ambulance community for a national breakout of the geographic area definitions (rural, urban, and super rural) by zip code, we have prepared a table (see Downloads section below).  Please note that it is arranged by State (using each State’s two-letter postal abbreviation), and, within each State, all zip codes are listed.  There are two sides to the table – the current geographic area breakout on the left and the geographic area breakout under the Proposed Rule, which was published on May 26, 2006 on the right.  The Medicare contractor number and the locality are also included.  Please note that, in the far right column for each side of the table, R = Rural, Blank = Urban, and B = Super Rural.  None of the Super Rural areas has changed.  Please search for your State, then zip code within the State, and compare the two sides of the table to determine if your geographic area definition changes under the Proposed Rule discussion.

AMBULANCE SERVICES CENTER
For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) ambulance suppliers, go to the Ambulance Services Center (see under “Related Links Inside CMS” below).

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Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital outpatient services, certain Part B services furnished to hospital inpatients who have no Part A coverage, and partial hospitalization services furnished by community mental health centers. The provisions of this section were further modified by sections 201 and 202 of the Balanced Budget Refinement Act of 1999 (BBRA).

All services paid under the new PPS are classified into groups called Ambulatory Payment Classifications or APCs. Services in each APC are similar clinically and in terms of the resources they require. A payment rate is established for each APC. Depending on the services provided, hospitals may be paid for more than one APC for an encounter.

Section 4523 of the BBA also changed the way beneficiary coinsurance is determined for the services included under the PPS. A coinsurance amount will initially be calculated for each APC based on 20 percent of the national median charge for services in the APC. The coinsurance amount for an APC will not change until such time as the amount becomes 20 percent of the total APC payment. In addition, Section 204 of the BBRA provides that no coinsurance amount can be greater than the hospital inpatient deductible in a given year.

Both the total APC payment and the portion paid as coinsurance amounts will be adjusted to reflect geographic wage variations using the hospital wage index and assuming that the portion of the payment/coinsurance that is attributable to labor is 60 percent. CMS’s final rule for the new system was published in the Federal Register on April 7, 2000 (65 FR 18434). The new system went into effect on August 1, 2000.

Source: http://www.cms.hhs.gov/HospitalOutpatientPPS/

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