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May8
0

New Medicare Cards Are On The Way: How To Avoid Being Scammed

By Tom Matteson - blog
The federal government is delaying the mailing of new Medicare cards as it beefs up security measures. (Contributed photo/CMS)
The federal government is delaying the mailing of new Medicare cards as it beefs up security measures. (Contributed photo/CMS)
By Leada Gore
04/17/2018

Medicare officials are mailing out new identification cards as they beef up security measures while warning of possible scams.

Beneficiaries living in Delaware, Washington, D.C., Maryland, Pennsylvania, Virginia and West Virginia were scheduled to begin receiving their new Medicare ID cards in April. Instead, the new schedule has pushed the delivery date back to May.

“We are working on making our processes even better by using the highest levels of fraud protection when we mail new cards to current Medicare beneficiaries,” the Centers for Medicare and Medicaid Services said.

New Medicare enrollees will automatically receive the new card, regardless of where they live.

The change comes as Medicare officials are working to crack down on fraud. Previously, Medicare cards contained the holder’s Social Security numbers. The new cards remove the Social Security number and replace it with a new 11-digit randomly assigned number called a Medicare Beneficiary Identifier or MBI.

Medicare card scams

The planned mailout of new Medicare cards has scammers looking to cash in.

Here’s what to be looking out for, according to CMS:

Medicare will never call you uninvited and ask for personal or private information and you do not have to provide this information to receive a new card. The new Medicare card will be mailed automatically to beneficiaries.

Do not give out your Social Security number or new MBI to anyone who contacts you about your card. If someone asks you for your information, for money, or threatens to cancel your health benefits if you don’t share your personal information, hang up and call us at 1-800-MEDICARE (1-800-633-4227).

You can go here to sign up for an alert letting you know when your new card is mailed.

Once you get your new Medicare card, destroy your old Medicare card and start using your new card right away.

May2
0

Great Job Morgan!

By Tom Matteson - blog

MIC would like to congratulate Morgan Novak for qualifying for the 69th annual Future Masters Tournament in Dothan Alabama.  Great Job Morgan!

May1
0

Medicare trying to combat opioid use.

By Tom Matteson - blog

Opioid is not just impacting the younger generation it is also impacting the senior community.  Here is a great article written by the New York Times that dives into the subject

Written By

Jan Hoffman

March 27, 2018

 

Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of the 43.6 million beneficiaries of the program’s drug plan had been prescribed the painkillers.

Medicare, they decided, would now refuse to pay for long-term, high-dose prescriptions; a rule to that effect is expected to be approved on April 2. Some medical experts have praised the regulation as a check on addiction.

But the proposal has also drawn a broad and clamorous blowback from many people who would be directly affected by it, including patients with chronic pain, primary care doctors and experts in pain management and addiction medicine.

Critics say the rule would inject the government into the doctor-patient relationship and could throw patients who lost access to the drugs into withdrawal or even provoke them to buy dangerous street drugs. Although the number of opioid prescriptions has been declining since 2011, they noted, the rate of overdoses attributed to the painkillers and, increasingly, illegal fentanyl and heroin, has escalated.

“The decision to taper opioids should be based on whether the benefits for pain and function outweigh the harm for that patient,” said Dr. Joanna L. Starrels, an opioid researcher and associate professor at Albert Einstein College of Medicine. “That takes a lot of clinical judgment. It’s individualized and nuanced. We can’t codify it with an arbitrary threshold.”

Photo

Mr. Zobrosky’s medication regimen is strictly monitored at home. He submits to random urine tests and brings his pills to his doctor to be counted.CreditEamon Queeney for The New York Times

Underlying the debate is a fundamental dilemma: how to curb access to the addictive drugs while ensuring that patients who need them can continue treatment.

The rule means Medicare would deny coverage for more than seven days of prescriptions equivalent to 90 milligrams or more of morphine daily, except for patients with cancer or in hospice. (Morphine equivalent is a standard way of measuring opioid potency.)

According to Demetrios Kouzoukas, the principal deputy administrator for Medicare, it aims to further reduce the risk of participants “becoming addicted to or overdosing on opioids while still maintaining their access to important treatment options.”

The Centers for Medicare and Medicaid Services estimates that about 1.6 million patients currently have prescriptions at or above those levels. The rule, if approved as expected at the end of a required comment and review period, would take effect on Jan. 1, 2019.

Dr. Stefan G. Kertesz, who teaches addiction medicine at the University of Alabama at Birmingham, submitted a letter in opposition, signed by 220 professors in academic medicine, experts in addiction treatment and pain management, and patient advocacy groups.

His patients include formerly homeless veterans, many of whom have a constellation of physical and mental health challenges, and struggle with opioid dependence. For them, he said, tapering opioids does not equate with health improvement; on the contrary, he said, some patients contemplate suicide at the prospect of suddenly being plunged into withdrawal.

“A lot of the opioid dose escalation between 2006 and 2011 was terribly ill advised,” Dr. Kertesz said. “But every week I’m trying to mitigate the trauma that results when patients are taken off opioids by clinicians who feel scared. There are superb doctors who taper as part of a consensual process that involves setting up a true care plan. But this isn’t it.”

Some two dozen states and a host of private insurers have already put limits on opioids, and Medicare has been under pressure to do something, too. Last July, a report by the inspector general at the Department of Health and Human Services raised concerns about “extreme use and questionable prescribing” of opioids to Medicare recipients. In November, a report from the Government Accountability Office took Medicare to task, urging greater oversight of opioid prescriptions.

If the rule takes effect, Mark Zobrosky’s experience could be a harbinger for many patients. Mr. Zobrosky, 63, who lives in the North Carolina Piedmont, takes opioids for back pain, which persists despite five surgeries and innumerable alternative treatments. He has an implanted spinal cord stimulator that sandpapers the edge off agony, and has broken four molars from grinding because of pain, he said. He receives Medicare as a result of his disability, including a private plan that pays for his drugs.

He submits to random urine tests and brings his opioids to his doctor to be counted every month. To prepare for mandatory reductions, his doctor has tapered him down to a daily dose equivalent of about 200 milligrams of morphine. (Mr. Zobrosky has a large frame; doctors say that opioid tolerance depends on many factors — one person’s 30 milligrams is another person’s 90.)

In February, Mr. Zobrosky’s pharmacist told him that his insurance would no longer cover oxymorphone. His out-of-pocket cost for a month’s supply jumped to $1,000 from $225, medical records show. “I can’t afford this for very long and I’m nervous,” he said.

A Medicare official who would speak only on background said that the limit for monthly high doses was intended not only to catch doctors who overprescribe, but also to monitor patients who, wittingly or not, accumulate opioid prescriptions from several doctors. When the dose is flagged, the pharmacist or patient alerts the doctor.

But it falls to pharmacists to be the bad-news messengers. James DeMicco, a pharmacist in Hackensack, N.J. who specializes in pain medications, said that negotiating opioid insurance rejections for patients was already “beyond frustrating.” He spends hours shuttling between doctors and insurers. “My heart goes out to patients because they feel stigmatized,” he said.

Dr. Anna Lembke, an addiction medicine expert at Stanford, sees merit in the intent of the proposed rule, if not its design.

“The C.D.C. declared a drug epidemic in 2011, which they unequivocally and rightly attributed to overprescribing,” she said. “Without external limits, I do not believe that prescribers will be able to limit their prescribing to the extent necessary to address this public health crisis.”

But, she added, Medicare also needed to establish a reasonable grace period to allow patients on high doses to taper down safely.

According to a draft of the rule, when a high-dose prescription is rejected, a doctor can appeal, asserting medical necessity — although there is no guarantee that the secondary insurer covering the drugs under Medicare would relent. A pharmacist may fill a one-time, emergency seven-day supply.

Opponents of the new limit say that doctors are already overwhelmed with time-consuming paperwork and that many will simply throw up their hands and stop prescribing the drugs altogether.

A delay or denial would put chronic pain patients — or those with inflammatory joint diseases, complex shrapnel injuries or sickle cell disease — at risk of precipitous withdrawal and resurgence of pain, doctors said.

The Medicare proposal relies on guidelines from the Centers for Disease Control and Prevention that say doctors should not increase an opioid to a dose that is the equivalent of 90 milligrams of morphine.

But experts say that Medicare misread the recommendations — that the C.D.C.’s 90-milligram red flag is for patients in acute pain who are just starting opioid therapy, not patients with chronic pain who have been taking opioids long-term. The acute pain patient, the guidelines say, should first be offered treatments like acetaminophen or ibuprofen. A short course of a low-dose opioid should be a last resort.

“We didn’t take a specific position on people who were already on high doses,” said Dr. Lewis S. Nelson, the chairman of emergency medicine at Rutgers New Jersey Medical School and University Hospital, who worked on the guidelines.

“We did say that established, high-dose patients might consider dosage reduction to be anxiety-provoking, but that these patients should be offered counseling to re-evaluate,” he added. “There is a difference between a C.D.C. guideline for doctors and a C.M.S. hard stop for insurers and pharmacists.”

Dr. Erin E. Krebs recently released a comprehensive study showing that patients with severe knee pain and back pain who took opioid alternatives did just as well, if not better than, those who took opioids. Nonetheless, she and seven others who worked on the C.D.C. guidelines signed the letter opposing the Medicare rule.

“My concern is that our results could be used to justify aggressive tapering or immediate discontinuation in patients, and that could harm people — even if opioids have no benefit for their pain,” said Dr. Krebs, an associate professor of medicine at the University of Minnesota.

“Even if we walk away from using opioids for back and knee pain, we can’t walk away from patients who have been treated with opioids for years or even decades now,” she added. “We have created a double tragedy for these people.”

Apr30
2

Changes to Medicare in 2018

By MedicareIC - blog

 

There are a few changes that have happened in 2018 to Medicare.  It is important to understand how they may impact you, now and going forward.  Below is a great article by Forbes that highlights all of the changes:

Article Written By

David Haass

04/14/2018

So far, 2018 has brought many new changes for Medicare patients. If you’re a Medicare agent or have a Medicare plan, you should be aware of these changes. Here are some of the biggest changes that you will see this year, including information and resources regarding new Medicare cards that will begin to be mailed out in April.

Medicare Part A

Deductibles have increased to $1,340 per benefit period. The deductible for 2017 was $1,316.

Hospital coinsurance has also undergone a $6 per day increase for days 61-90 of hospitalization. Beneficiaries are covered for shared costs for the first 60 days. Beneficiaries in a skilled nursing facility sawan increase in their daily coinsurance for days 21-100 of $3 from 2017. Lifetime reserve days have increased from $658 to $670 per day.

Medicare Part B

The annual deductible for Medicare Part B has stayed the same for 2018, as have the standard premiums. However, there are a few major changes to take note of.

Hold Harmless

Those who are protected by the “hold harmless” provision saw an increase. The hold harmless rule applies if you collect Social Security benefits and your Medicare Part B premium is deducted from those benefits each month. Most Medicare beneficiaries are covered by this.

IRMAA

If you have a higher income and therefore pay the Income Related Monthly Adjustment Amount (IRMAA), you may have also seen your premium increase.

IRMAA works in tiered income patterns. The first two tiers remained the same as far as premium surcharges. However, those who fall into higher tiers may be seeing higher premium surcharges in 2018 as a result of the Medicare Access and CHIP Reauthorization Act (MACRA). The income levels in tiers three through five were changed this year, meaning you may have gone from paying 50% of Part B costs to 65% or even 80%.

Medicare Part D

The Part D deductible for Medicare patients will increase slightly in 2018 from $400 to $405. Beneficiaries should be happy to see a $50 increase in their initial coverage limit for Medicare Part D. The new limit for 2018 is $3750. The out-of-pocket threshold for Medicare in 2018 is $5,000, which is $50 more than in 2017. The maximum copay for 2018 is $3.35 for generic drugs and $8.35 for other drugs.

New Medicare Cards

In order to protect Medicare beneficiaries from medical identity theft, the centers of Medicare & Medicaid Services (CMS) are removing social security numbers from Medicare cards and replacing them with unique Medicare Beneficiary Identifier (MBI) numbers.

Starting in April 2018, the new Medicare cards with MBIs will begin the process of being mailed out in phases by geographic location. This process is expected to be completed by April 2019. Beginning January 1, 2020, only new cards will be usable.

10 Things Medicare Beneficiaries Should Know About Their New Medicare Cards

1. Your card is being mailed out based on geographic location, but your card could arrive at a different time from your neighbor’s.

2. Once you receive your new Medicare card, destroy the old one.

3. Only give your new Medicare card number to people you trust to handle your Medicare on your behalf.

4. Know that your new Medicare number is unique to you.

5. Your new card is paper, so if you ever need a replacement card, you can print one.

6. Always keep your new card with you.

 7. Your healthcare facilities and providers will be asking for your new card at your next visit.

8. If you forgot your new card at home, don’t worry. Your healthcare provider or doctor can look it up online.

9. If you’re on Medicare Advantage, your plan ID card is still your main card for Medicare. Make sure to carry your ID card as well as your new Medicare card on you.

10. If you don’t receive your new Medicare card by April 2019, call 1-800-MEDICARE.

How Medicare Agents Can Prepare For New Medicare Cards

While CMS is trying to make the new Medicare card transition as smooth as possible, there are a few steps Medicare agents should take and resources to use to prepare.

1. Prior to April 1, 2018, update your business and system processes so that they can accept the new MBI numbers.

2. Become familiar with the preferred language and termswhen talking about the new Medicare cards.

 3. Understand the Medicare Beneficiary Identifier (MBI) format.

4. Add widgets to your website with a link to go.medicare.gov/newcard.

 5. Begin social media outreach using the Partner Social Media Toolkit provided by CMS.

6. Download and review the 2018 partner update slides.

Thankfully, CMS has provided many resources for Medicare agencies and agents to use in order to help educate and bring awareness to people with Medicare. Make sure to check CMS partners and employers overview page regarding the new Medicare cards often for new information and resources.

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