New Tips to Prevent Medical Identity Theft and Medicare Fraud

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Secretary of Health and Human Services Kathleen Sebelius and Assistant Attorney General Tony West today highlighted the Obama Administration’s work to fight Medicare Fraud and released new tips and information to help seniors and Medicare beneficiaries deter, detect and defend against Medical identity theft.

Medicare: Transparency and Open Government by President Obama

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My Administration is committed to creating an unprecedented level of openness in Government. We will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.

HHS Highlights Innovative New Open Government Initiatives

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Part of Open Government Commitments in Service of National Priorities Programs Are Result of Accessible Federal Decision Making Process — HHS Secretary Kathleen Sebelius announced today three innovative HHS ideas that have been developed as a result of a more open and accessible federal decision making process in collaboration between the public, private sector and the federal government.

Medicare Health Plan Enrollees Receive a Notice of Medicare Non-Coverage

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Medicare health plan enrollees receive a Notice of Medicare Non-Coverage (NOMNC) prior to termination of Medicare-covered skilled nursing facility (SNF), home health (HH), and comprehensive outpatient rehabilitation facility (CORF) services

Medicare Part B Drug Average Sales Price – Help and Assistance

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Manufacturer reporting of Average Sales Price (ASP) data: A manufacturer’s ASP must be calculated by the manufacturer every calendar quarter and submitted to CMS within 30 days of the close of the quarter. Each report must be certified by one of the following: the manufacturer’s Chief Executive Officer (CEO); the manufacturer’s Chief Financial Officer (CFO); an individual who has delegated authority to sign for, and who reports directly to, the manufacturer’s CEO or CFO.

CMS Home, Medicare, Medicare Contracting Reform, Overview

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CMS’ mission is to ensure health care security for beneficiaries. A major component in achieving this mission is the successful administration of Original Medicare, or Fee-for-Service (FFS) Medicare. Medicare Contracting Reform (or section 911 of the Medicare Prescription Drug,

Medicare Help for Flu Like Symptoms

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Persons with Disabilities: The term “disability” refers to limited physical or cognitive capacity. It includes people with neurological and neuro-developmental conditions, such as disorders of the brain, spinal cord, peripheral nerve, and muscle (e.g., cerebral palsy, epilepsy/seizure disorders, stroke, intellectual disability/mental retardation); moderate to severe developmental delay; muscular dystrophy; and spinal cord injury. These chronic conditions interfere with functional capacity. “Disability” also includes people with other chronic health conditions that interfere with functional capacity.

Medicare beneficiaries will not see a Part B monthly premium increase

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Most Medicare beneficiaries will not see a Part B monthly premium increase as a result of a “hold harmless” provision in the current law. This allows for 73 percent of beneficiaries to be protected from an increase raising the 2010 Part B monthly premiums from $96.40 to $110.50.

Medicare: New Standards for Tougher Error Rate

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For 2009, CMS improved how it reviews Medicare claims for inpatient hospital services and eliminated the use of past billing records as part of a complex medical review. As a result of this heightened scrutiny and more complete accounting of Medicare FFS claims, CMS is reporting a 2009 FFS error rate of 7.8 percent, or $24.1 billion, compared to 3.6 percent in 2008. In addition, for 2009:

Medicare Expands List of Covered Preventive Services to Include HIV Screening Tests

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The Centers for Medicare & Medicaid Services (CMS) today announced its final decision to cover Human Immunodeficiency Virus (HIV) infection screening for Medicare beneficiaries who are at increased risk for the infection, including women who are pregnant and Medicare beneficiaries of any age who voluntarily request the service.

Social Security Hearings Backlog Down

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Michael J. Astrue, Commissioner of Social Security, today announced that for the first time since 1999, the agency has ended the year with fewer disability hearings pending than in the prior year. Social Security ended fiscal year (FY) 2009 with 722,822 hearings pending compared to 760,813 hearings pending at the start of the year, a reduction of more than 37,000 cases. Over the same period, the average processing time for these cases improved from 514 days in FY 2008 to 491 in FY 2009.

Economic Recovery Act Payment for 2010 Needed

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With consumer prices down over the past year, monthly Social Security and Supplemental Security Income benefits for more than 57 million Americans will not automatically increase in 2010. This will be the first year without an automatic Cost-of-Living Adjustment (COLA) since they went into effect in 1975.