Showing posts with label cms. Show all posts
Showing posts with label cms. Show all posts

Wednesday, June 27, 2012

Medicare Savings on Prescription Drugs for Seniors as a Result of the Affordable Care Act




According to the Centers for Medicare and Medicaid Services More than 5.2 million Medicare beneficiaries have saved a total of $3.7 billion on their prescription drugs since the health care reform law (a.k.a. Affordable Care Act a.k.a. "Obama Care") went into effect.   The Affordable Care Act—also known as health care reform—which passed in 2010, required financial assistance for seniors who fall into Medicare's so-called "donut hole." As a result of health care reform, Medicare beneficiaries who fell into the donut hole in 2010 received $250 as a one-time, tax-free rebate to help pay for their prescription drugs. Even more relief came into effect in 2011 as the law also required that those Medicare beneficiaries who fell into the donut hole because of high prescription drug costs should receive a 50 percent discount on covered brand-name drugs, and 7 percent coverage of generics.

See CNN Article: http://money.cnn.com/2012/06/25/pf/health-reform-medicare/

Polls show that more Americans are opposed to the Affordable Care Act than those that approve it.  Some commentators claim this is because opponents have spent 235 Million dollars in ads criticizing the law where only 69 Million has been spent in ads supporting the law. 

See New York Times Report: http://www.nytimes.com/2012/06/21/health/policy/health-care-law-loses-ad-war.html?_r=1&em

On the other hand see the benefits of the law: http://www.whitehouse.gov/the-press-office/2012/03/23/new-report-affordable-care-act-gives-americans-more-security-better-bene
The nation eagerly await the Supreme Court's decision regarding the constitutional challenges initiatedby Republicans and conservatives alike. The Affordable Care Act has an "Individual Mandate" that requires everyone to have insurance coverage or they will be fined. Provisions are included in the Act to subsidize insurance coverage for those who can afford it. The rationale behind this is that everyone has a basic right to healthcareand that it will be less costly if everyone is covered. Opponents claim that the requirement force people to buy an insurance policy is unconstitutional and that the federal government does not have the right to force people to do this. However, the commerce clause, has been used in scores of cases as a constitutional basis for the federal government to enact laws where the economic affect of the law crosses state lines.


Attorney Casiano founded the Casiano law firm in San Diego Elder Law and Estate Planning Firm to serve the needs of seniors and their families with the complex legal issues that arise as one grows older.  If you have any questions regarding your Medicare, Medicaid, or Medi-Cal coverage, feel free to give "Vinny" a call at 619-800-6820 and he will speak to you at no charge to see if he can assist you.


Tuesday, June 24, 2008

New Rating System for Nursing Homes

The Centers for Medicare and Medicaid Services (CMS) announced this week the implementation of a new rating system for nursing homes. Nursing homes will soon be rated on a 5-star scale, similar to the way hotels and restaurants are currently rated by critics, with one star being the lowest rating and five stars the highest possible rating. The new system is designed to assist families in determining the best facilities in their area. The new system will appear on Medicare’s “Nursing Home Compare” Web site, hopefully before the end of 2008.

Nursing Home Compare basic staffing information, general findings of inspection reports for the past three years, and a list of quality indicators. Quality indicators include the percentage of residents subject to some form of restraint; percentage of residents with pressure sores; and percentage of residents who have lost too much weight. Some have criticized the current Web site as being difficult to navigate.

The new system is designed to make it easier for consumers to evaluate a home and distinguish one facility’s performance from another. Proponents of the new system believe it will hold nursing homes accountable and force underperforming facilities to improve their standard of care.

CMS is currently holding a period of public comment to determine the best method of translating inspection reports and quality indicators into star ratings and to allow the public to suggest other information that should be included in the ratings. Many hope that the ratings will take into consideration resident satisfaction surveys, which most homes already conduct on an annual basis. Advocates of including these survey results in the ratings state that it is important to give the families of the residents some input in the facility’s rating. The first ratings are expected to be completed by December. Ratings will be updated quarterly.

Regardless of the new rating system, it is important to personally check out a nursing facility. A rating system should not be a substitute for your own observations and best judgment. If you have a comment, feel free to post it here, but keep in mind your posting will not be confidential. If you have a question or need assistance with a matter involving a nursing home or assisted living facility, call my office for immediate assistance. Thanks for reading my blog.