**READ HERE** If you want to discuss this debate, go to the blogs that have linked to the video (see underneath the video for links). 9/26/07 Democrats Debate, Part J. Tim Russert moderates. In this clip, Tim Russert asks Joe Biden, Hillary Clinton Barack Obama Chris Dodd and Bill Richardson about social security and medicare.

December 17, 2009

It appears that the U.S. Senate will vote to close debate on its version of federal health care reform as early as this weekend. Whether or not you have contacted your senators previously, now is the time for you to consider contacting both of your senators and encourage them to continue debate and to improve the legislation.

Quoting & Saving just got easier…Easy To Insure ME Health Insurance Quotes… Quote all carriers in seconds

Individual health insurance
Health insurance quote

It is difficult to overstate the negative implications of Senate Majority Leader Harry Reid’s (D-NV) proposal. According to the Congressional Budget Office, this legislation – if enacted – will have a significant, negative impact on the cost and nature of coverage for our customers. The administration’s chief actuary for Medicare and Medicaid Services has determined that if the Senate health care bill became law, it would increase national health care spending more than if we did nothing. Our own analysis concurs with these assessments and further indicates that Sen. Reid’s proposal will likely lead to higher premiums for many of our customers without reducing the growth in underlying health care costs.

A new Washington Post-ABC News poll indicates that 53% of Americans understand that their personal costs will increase under this proposal and only 37% believe that their personal health care will improve under this legislation. The Senate needs to set aside this version of health care reform and construct a proposal that has broad and deep public support.

Throughout the health care reform debate, our company has sought to partner with our elected leaders in both parties to pursue responsible, sustainable reform that lowers costs and increases access. The current legislation does not meet these goals and Congress needs to hear from individuals who are concerned about the consequences of well-intended but flawed reforms.

While we continue to support health care reform, we cannot support reform that fails to address the cost and quality issues in our health care delivery system and undermines the bipartisan consensus for responsible and sustainable reform.

The holiday season is a busy time for all. Now is the time to get involved today.

The Senate needs to hear from you and time is short.

(MedPage Today) -- Overweight patients with cardiovascular risks who took the weight-loss drug sibutramine had an increased likelihood of experiencing a cardiac event, a large randomized trial found.

Hey, check out these auctions:

Cool, arent they?

RT @CollardGreen: Hey u know what I always say! When life gives u lemons make a baby an use there social security number!• Lmfao – by SexciAsh (Sexciash)

Bring in Your wellness policy program body of do work because You

No more count however avidly you acquire attention from your wellness, in that location is out of the blue conditions that give notice a people you an daytime or cardinal inward the infirmary. Whenever you is not developed and you don’t consume sufficiency wellness insurance policy reporting, these give notice cold shoulder a bang-up business deal on your rescues. Therefore, it constitutes one and the same of import that you select the better wellness insurance policy programme that could assistance you in display case from a parking brake.

Beginning, assure come out completely the wellness policy choices that you accept. Believe your classes wellness calls for in addition to while signing-up because a insurance policy program. In that respect is deuce characters from wellness policy project that you force out sign on since: individual and politics wellness insurance policy choices. The individual wellness policy makes up in person signed-up because aside a somebody. You leave as well experience an wellness insurance policy design once you is applied. The keep company testament allow for you on insurance coverage because component from your employee profits.

The wellness insurance policy reportage allowed for through the governing may constitute offered up on-duty an topical, country or subject even out. Medicare equals a exemplar from an wellness insurance policy project popped the question on-duty an general degree. Medicare profits is usable because multitude who is concluded sixty-five a long time of historic period, and to individuals on handicaps. Extra government-initiated wellness insurance policy platforms let in: Medicaid, the express Children

Whenever you would like to sign on because an common soldier wellness insurance policy project, acquire everything that you involve to experience just about the insurance coverage qualified during your compact. Study the reporting selective information and bank check the divisions putting forward the exceptions. Head off contracting improving because one and only which consumes a farseeing broadcast from ejections that wouldn’t cover charge a great deal from anything. Additional significantly, make don’t mention it that you deliver an written matter from all constrict that you wish contract. Assure to them that your individualised reality costs counterbalance and bring in an government note from the insurance coverage geological period. All successful completely, be sure that you experience plentiful wellness insurance policy reporting because you to employment if you motivation them.

Tanoury, Jr. talks about reforming the Medicaid and Medicare process, and ending abuse and fraud. www.larrytanoury.net for more information.
Video Rating: 5 / 5

Did you know that for a limited time we are paying out (75% + 25% via PayPal®) 100% commissions. Visit www.profitpal.com for more info.
Stream Movies – 100% Commissions on Profitpal.com

Physicians, providers and suppliers providing services under Part A of Medicare, who have been subject to Medicare audits or claim denials resulting in overpayment demands, are aware that, currently if a Medicare fiscal intermediary identifies an alleged overpayment, the intermediary will immediately begin recouping the alleged overpayment without first granting the provider time to submit an appeal.  Specifically, the fiscal intermediary standard system (“FISS”) adjusts a claim, and if claims are in the system, immediately recoups.  This process does not provide Part A providers time to appeal an overpayment determination before the fiscal intermediary begins withholding funds.  The Centers for Medicare and Medicaid Services (“CMS” or “Medicare”) recently published a One-Time Notification, which instructs fiscal intermediaries and carriers regarding limitations on Medicare’s authority to recoup certain overpayments.

The One-Time Notification addresses recent changes made to the Social Security Act, which limit Medicare’s authority to recoup alleged overpayments during the Medicare appeals process.  Section 935 (a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (“MMA”) added Section 1893 (f) (2) to the Social Security Act.  This portion of the law restricts Medicare’s authority to recoup overpayments during parts of the Medicare appeals process.  Pursuant to Section 1893 (f) (2) (A):

In the case of a provider of services or supplier that is determined to have received an overpayment under this title and that seeks a reconsideration by a qualified independent contractor on such determination… the Secretary may not take any action (or authorize any other person, including any Medicare contractor…) to recoup the overpayment until the date the decision on the reconsideration has been rendered…

Prior to the enactment of Section 1893 (f) (2), a provider’s appeal of an overpayment determination did not impact Medicare’s authority to recoup an alleged overpayment.  Medicare was authorized to recoup alleged overpayments at all times during the appeals process.  Section 1893 (f) (2) limits Medicare’s authority to recoup alleged overpayments during the appeals process.  Generally speaking, the law requires that if a provider seeks a reconsideration of an overpayment determination, then Medicare and its contractors may not recoup the alleged overpayment until the qualified independent contractor (“QIC”) issues a reconsideration decision.

Significantly, the QIC reconsideration stage of appeal is the second stage in the Medicare appeals process.  The statute is unclear whether Medicare may recoup or withhold funds during the first stage of appeal (the redetermination stage), and after this stage until a request for reconsideration has been filed.  Notably, Medicare has not yet adopted regulations implementing Section 1893 (f) (2), which would provide clarification.  A proposed rule was published September 22, 2006,[1] however, a final rule has not yet been adopted.

In the absence of specific regulatory language to the contrary, an argument can be made that the statute prohibits Medicare from recouping once an appeal has been made at the first stage of appeal (redetermination) through the second stage of appeal (reconsideration).  However, an argument can also be made that the statute only prohibits Medicare from recouping during the reconsideration stage of appeal, and thus Medicare would be permitted to recoup during the first stage of appeal, until a request for reconsideration is filed.

The One-Time Notification addresses the statutory ambiguity and adopts the recoupment policies articulated in the proposed rule.  The One-Time Notification specifically addresses Part A overpayments, and instructs intermediaries that the receipt of a timely and valid request for redetermination at first stage of appeal will trigger limitation on recoupment.  Specifically, the recoupment process will be as follows: 

Once the intermediary renders an unfavorable initial determination, finds an overpayment to exist, and adjusts the claim in FISS, withholding will automatically begin 40 days from the date of initial determination. 
If a provider files a request for redetermination in the 40 days following the adverse initial determination, then Medicare will not initiate withhold activities.  Notably, pursuant to the federal regulations governing the Medicare appeals process, a provider has 120 days from the date of initial determination to file its request for redetermination.  However, if the provider chooses to utilize this entire time period, then the provider must be aware that Medicare will begin withholding until the request for redetermination is filed. 
If the redetermination decision results in a full or partial affirmation of the overpayment, then the intermediary may begin withholding funds beginning 60 days and no later than 75 days after giving notice, unless the provider first appeals a request for reconsideration to the QIC. 
The intermediary may not initiate recoupment once a valid and timely request for reconsideration has been filed.  Notably, pursuant to the federal regulations governing the Medicare appeals process, a provider has 180 days from the date of redetermination decision to file its request for reconsideration.  However, as noted above, the intermediary may begin withholding between 60 and 75 days from the date of redetermination decision.  It may be tempting for providers to quickly appeal an unfavorable redetermination decision to stop the intermediary from withholding funds.  However, it may be advantageous for the provider to take some additional time to carefully put together its appeal.  The regulations require providers to present all evidence, allegations of fact or law related to the issues in dispute, and explain its reasons for disagreement when filing a reconsideration request.  Absent good cause, the failure of a provider to submit evidence prior to issuance of the reconsideration decision precludes subsequent consideration of the evidence. 
Once the qualified independent contractor issues its decision, the intermediary may begin recoupment, regardless of whether the provider subsequently proceeds to the third stage of appeal and requests an Administrative Law Judge hearing. 

The CMS One-Time Notification is effective July 1, 2008 and will be implemented July 7, 2008.  The notification is available online at www.cms.hhs.gov/transmittals/downloads/R322OTN.pdf.

 

[1] 71 Fed. Reg. 55404 (September 22, 2006).

Insider Strategies to Get Free or Discounted Flights, Hotels, Car Rentals and Vacations. Affiliates Earn 65%.
Cheap Airfare Secrets – Travel Experts Expose Insider Discounts

“Get Covered. Get in the Game.” brings together coaches, schools, and communities to educate families with children who are eligible for Medicaid or Child Health Plus and can immediately avail themselves of free and low cost children’s health care programs. New York State Health Department Commissioner Richard Daines, Christian Engle, Vice-President of Operation for the Capital District YMCA, and Sue Kelly, the associate regional administrator for Medicaid and Children’s health at the US Centers for Medicare and Medicaid Services, were at the North Albany Y today to kickoff the Empire State’s launch of “Get Covered.”