medicare
Could we see a “two-tier” Medicare program?
Did you know that there are roughly 67 million Medicare patients, and 54 percent of them are in a Medicare Advantage plan? Medicare patients make up a large part of many physicians’ practices; however, physicians treating Medicare patients are seeing…
Social Security Adds 13 Conditions to Compassionate Allowances List
(Source: SSA.gov) The Social Security Administration (SSA) today announced the addition of 13 new conditions to the agency’s Compassionate Allowances (CAL) list. The CAL initiative accelerates the disability application process for individuals with the most serious diseases and medical conditions…
Your first Medicare billing surprise
Around your 65th birthday, you will have a 7-month window of time when you can sign up for Medicare. It is called your Initial Enrollment Period — or IEP for short. Your IEP includes your 65th birthday month, as well…
The next step in preventing fraud
In recent weeks, the Centers for Medicare & Medicaid Services (CMS) announced that the “Fraud Takedown” resulted in the prosecution of over 300 defendants who committed over $14.6 billion worth of fraud against the Medicare program. The Medicare program is…
CMS releases 2026 Medicare Part D Information
The Centers for Medicare & Medicaid Services (CMS) has released preliminary technical Medicare Part D bid information for the 2026 contract year, which will help Part D plans finalize their Part D and Medicare Advantage (MA) offerings for 2026. As…
United Healthcare billing practices being scrutinized by Dept. of Justice
Probably the nation’s largest healthcare provider, United Healthcare (UHC) Group, has confirmed that it will fully cooperate with an investigation by the Federal Department of Justice (DOJ) into its Medicare billing practices. Professing full confidence that UHC’s billing processes are…
Should “means testing” exist for Social Security and Medicare?
In this somewhat unconventional opinion piece, the author opines that both the Social Security and Medicare programs are suffering financial difficulties, largely because many who receive benefits do not actually need them. The author, himself a fairly affluent businessman, contends…
What you should know about Medicare
Medicare is the nation’s most important healthcare program. In fact, over 68 million people are now enrolled in this important program, enacted in 1965 by President Lyndon Johnson. But as encompassing and important as Medicare is, it doesn’t cover all…
Prior Authorization Targeted by CMS Medicare
Under the guise of fraud and waste prevention, the Centers for Medicare & Medicaid Service (CMS),along with dozens of large healthcare insurance companies, have revealed forthcoming changes to the “Prior Authorization” process. Prior Authorization is a process used by various…
Demystifying the Federal Payroll Tax
Nearly all workers pay it, but very few understand it – the Federal Payroll Tax. With few exceptions,[1] everyone who works and earns pays the federal payroll tax from their earnings – that’s about 175 million American workers. The tax, first…