Thread: Medicare 1011 pymts for illegals and the cuts to seniors.

Seniors will lose the Medicare Advantage program and will find that their costs will rise. These same seniors are the ones that have paid into the medicare system for years. This is, to me, an example of the American bpeople being ripped off and shortchanged in order to pay for people that have no claim to any funds paid by U.S. taxpyers into programs that were supposed to be for the benefit of those that paid into it.

Please read the link to the article, I can not get it to copy.
http://www.dailyfinance.com/story/medic ... s/19578216

At the same time, in 2003, the government ammended the mdicare law to pay states for the cost of illegal aliens healthcare and the cost of some people coming from Mexico.

**Note: Updated Section 1011 information is maintained and can be accessed at the TrailBlazer website. See link in the "Related Links Outside CMS" section below.**

Section 1011, Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens, provides $250 million per year for fiscal years (FY) 2005-2008 for payments to eligible providers for emergency health services provided to undocumented aliens and other specified aliens. Two-thirds of the funds will be divided among all 50 states and the District of Columbia based on their relative percentages of undocumented aliens. One-third will be divided among the six states with the largest number of undocumented alien apprehensions.

From the respective state allotments, payments will be made directly to hospitals, certain physicians, and ambulance providers for some or all of the costs of providing emergency health care required under Section 1867 and related hospital inpatient, outpatient and ambulance services to eligible individuals. Eligible providers may include an Indian Health Service facility whether operated by the Indian Health Service or by an Indian tribe or tribal organization. A Medicare critical access hospital (CAH) is also a hospital under the statutory definition. Payments under Section 1011 may only be made to the extent that care was not otherwise reimbursed (through insurance or otherwise) for such services during that fiscal year.

Payments may be made for services furnished to certain individuals described in the statute as: 1) undocumented aliens; 2) aliens who have been paroled into the United States at a United States port of entry for the purpose of receiving eligible services; and 3) Mexican citizens permitted to enter the United States for not more than 72 hours under the authority of a biometric machine readable border crossing identification card (also referred to as a "laser visa") issued in accordance with the requirements of regulations prescribed under a specific section of the Immigration and Nationality Act.

http://www.cms.gov/undocAliens/Reimbursements by state in 2008
PDF
https://www.cms.gov/MLNProducts/downloa ... _Sheet.pdf

Here's the article for those who choose not to open links:

Medicare Reform Means Some Seniors Face Benefit Cuts
By CHARLES WALLACE Posted 6:30 AM 08/03/10 Economy, Health Care

First, the good news: According to a report released by the White House on Monday, America's new health reform law will generate $575 billion in Medicare cost savings over the next decade, allowing the program to survive until 2029. The report says this will result in lower Medicare premiums of nearly $200 a year by 2018.

Part of those savings, amounting to $5.3 billion by 2011, will come from reduced "overpayments" to Medicare Advantage, a system that allows Medicare recipients to receive benefits via private health insurance providers. The savings associated with Medicare Advantage efficiencies will rise to $145 billion by 2019.

Now for the bad news: Seniors enrolled in Medicare Advantage may soon find their that benefits have been cut. Under changes contained within America's new health reform law, reduced payments to private insurers may lead to a reduction in benefits such as dental coverage and free eyeglasses. That could trigger an exodus from Medicare Advantage plans back to traditional fee-for-service Medicare, though at much higher costs.

Shrinking the Subsidies

Since 2003, when the subsidies offered Medicare Advantage were greatly increased, the number of enrollees in such plans -- which are offered by a number of private insurance companies -- has soared. Roughly one in four Medicare recipients is now on a Medicare Advantage plan because of all the extra benefits that were offered.

The issue has become a central concern to many seniors, because the health reform law passed in March makes deep cuts in the subsidy payments Medicare makes to private Medicare Advantage plans. The Obama administration report says Medicare paid Medicare Advantage plans 14%, or $1,000 per person on average, more for health services than traditional Medicare, with "no measured differences in health outcomes." It is those extra payments that will now be eliminated.

Yet in one change to the rules which has not been widely reported, people enrolled in a Medicare Advantage plan will no longer be able to switch to another Medicare Advantage program. Instead, they will have no option but to join the traditional Medicare program if they decide to leave their current plans because benefits have been reduced under the new law.

Peter Ashkenaz, deputy director of media affairs at the U.S. Health and Human Services department of Medicare and Medicaid services, confirmed that as of Jan. 1, people enrolled in Medicare Advantage will have 45 days of open enrollment "to return to the fee-for-service program." But, he added, users will not be able to switch to another Medicare Advantage plan, as they have been able to do for the past decade.

The Challenge of Change

"Obviously if you're taking away subsidies, then [companies that provide Medicare Advantage] plans will have to review what the doing," says David Certner, legislative director for the AARP, formerly known as the American Association of Retired People. "We're likely to see some changes in some of plans."

The AARP, which supported the heath care reform law, also offers Medicare Advantage and Medigap insurance policies to its members. Certner says AARP's position is that its business side should conform to its policy side, and "that we needed to reduce some of these excess payments, but our plans would continue to operate in whatever the regime was."

Certner says the savings outlined by the Administration means the "financial solvency of Medicare is going to be improved by 12 years – that's pretty significant."

But, he added, there are concerns that projected savings in payments to health care providers like hospitals and nursing homes might limit access to those facilities. "Those are not likely to happen as much in the near term," but over longer periods of time they might have an impact, and "that's certainly something we'll be keeping our eyes on."

Mind the Gaps

Joseph Antos, a health care scholar at the American Enterprise Institute, says this change could prove extremely costly to retirees. That's because most seniors on Medicare Advantage don't have so-called Medigap policies, which are private insurance plans that pay the "gaps" in traditional Medicare coverage such as hospital deductibles and doctor co-payments.

Antos says that when patients switch from Medicare Advantage to traditional Medicare, "they will pay much higher premiums than they ever imagined possible for Medigap insurance." The reason is that most people take out Medigap coverage when they turn 65 and are healthy, while those who are older and in poorer health will now have to pay much more.

Antos said that based on the analysis of Richard S. Foster, the chief actuary of the Medicare service, some large hospitals and nursing homes may withdraw from providing Medicare services because the reimbursements are too low to be cost-effective.

See full article from DailyFinance: http://www.dailyfinance.com/story/medic ... _copyright

WHAT?!!!???

They are already killing us. This year, factoring in the donut hole, my husband's preferred insulin went from $3.50 to $350. He hasn't had it all year. Nobody has been able to help. Some ignoramus's offer other insulins that are cheaper - yes and even the doctor will tell you that they are known to kill people while they are sleeping.

Everybody in the central AZ that has APS is screaming right now because the corporation commission allowed them an increase that has doubled our electric bill. Our electric bill is $700 this month. It should be $350. People in small apartments who normally pay $80 to $175 are having bills stating $400.

The banksters routinely play with our bank accounts because nobody stops them. Just wait until you are retired or on Social Security. Being on Social Security is a huge flag to them that you are an acceptable target because rich people are often refused Social Security - so they know that those who do get it have few resources to fight. Fighting the banksters is almost a full-time job. You have to go on-line every day to catch how they are re-arranging all inbound and outbound on your account constantly in hopes of catching you so they can put the cascade of insufficient funds fees. If they can't do it this way they allow bogus firms into your account that takes out funds for unknown goods or services. Even after you spend so much time fighting them and you get a hardcopy letter stating that they will not allow the bogus firm into your account - the exact next day the same bogus firm is once again in your account taking out unauthorized funds. You have to have internet and time and energy to fight them. While doing this they are also turning you into their permanent customer because they are creating a bad record on you with their own shenanigans to where no other bank will allow you to open an account with them.

This is what they want. We can't be activists if we can't stay alive or even stay housed.

I AM CONVINCED THAT THE US CITIZEN IS BEING USED TO SUBSIDIZE AFFORDABLE HEALTH CARE AROUND THE PLANET. I KNOW PEOPLE IN OTHER NATIONS. NONE OF THEM PAY EVEN A MINUTE FRACTION OF WHAT WE HAVE TO PAY JUST FOR COMMON RX. THIS IS CRIMINAL!