Thursday, March 31, 2011

Physician Shortage and Health Care Reforms - 14

Physician Shortage and Health Care Reforms - 14 Video Clips. Duration : 7.03 Mins.

Question-and-answer session conducted by Rep. Roscoe Bartlett (R-MD) at the House Small Business Committee hearing The Looming Challenge for Small Medical Practices: The Projected Physician Shortage and How Health Care Reforms Can Address the Problem on July 8, 2009

Tags: house, small, business, committee, democrats, nydia, velazquez, roscoe, bartlett, physician, shortage, health, care, reform, doctor, medicine

Wednesday, March 30, 2011

What Reform We Can Bring to Curb health Care Fraud!

What have we created in condition care? A tower of Babel! While the shop attempts to correct itself and U.S legislative and executive field politicians most likely pursue their seventh endeavor since 1927 and President Obama made his way to the presidency by claiming that he will bring a revolution to the healthcare for the citizen of America, but now it's more than 3 years and we haven't seen praiseworthy impact of his reforms.

A part from a political overview, healthcare is a very sensitive issue in all parts of the world. Not only the third world underdeveloped countries, the countries like United States of America and European Union has all the time been seen in crisis over healthcare over the past decades, although the advancement in science, investigate and technology has brought wonders but still the condition care fraud and healthcare crimes are expanding in huge numbers.

Health Care Reforms

Actually we don't indubitably need a reform in the healthcare industry but we need an coming to find out the places where a extremely advanced country can also lack in services of healthcare. Picking out the condition care fraud right from its root cause can curb the question in a huge and choosing manner.

What Reform We Can Bring to Curb health Care Fraud!

Health care fraud is a crime which is not roaming nearby only to the healthcare victualer level but there are other major contributors like patients, tax payers, employers, assurance plan sponsors, and healthcare vendors also.

Health care fraud steals the very essence of human life. Stories comprise false claims by perpetrators, who perform needless procedures that disable or kill, fake assurance broker or inappropriate payer denials that leave a inpatient disabled or with untimely death, and fake drugs etc. The list of examples is more shocking and demoralizing and generates a sense of hopelessness.

10 Things Which Indicate a condition Care Fraud:

Medical incidents or medical practices that are not consistent with the thorough of care (substandard provision of healthcare). Unnecessary cost to a healthcare program caused either directly or indirectly. Improper payment or payment for services that fail to meet expert standards. Medically unnecessary services Substandard capability of care (e.g., in nursing homes) Elaborated Schemes and cover-up strategies and failure to meet assurance coverage requirements. False statement of services rendered or goods provided. Obtaining assurance facts and filing claims for fictitious medical treatment. Unreasonable rates and misrepresentation of value and services regarding healthcare. Consumer condition care fraud. One example is forging house names to contribute coverage to friends with the intention of dividing up the reimbursement.

Recommendations for stoppage of a condition Care Fraud:

Monitoring System:

Continuous monitoring of;

Patient activity. Provider activity. Payer activity. Employer activity. Vendor activity. Organized crime activity.

Prevention System:

Continuous improvement in;

Fraud stoppage goals. Fraud Deterrence strategies. Fraud detection methods. Fraud investigation criteria. Fraud loss and costs rescue system. Anti fraud controls, effectiveness and remediation measures. Antifraud schooling and Training.

What Reform We Can Bring to Curb health Care Fraud!

Tuesday, March 29, 2011

Health Care Reforms Go into Effect Today - WILX

Health Care Reforms Go into Effect Today - WILX Video Clips. Duration : 2.00 Mins.

Keywords: jason moon, ofir, health care reform

Monday, March 28, 2011

health Care Reform - How Are You Affected? - Part 2

To date, puny is known about specifics incredible to come from the two departments. Hhs will be the traditional driver however, while Dol will address union and other labor issues that arise.

Healthcare reforms do address a few specific areas by which employers, large and small, can plan. We do need to remember the final outcome of the law was not to sell out costs. Rather, the purpose was to growth way to condition insurance.

Health Care Reforms

The immediate timeline associated to all owner sponsored condition assurance plans look like this:

health Care Reform - How Are You Affected? - Part 2

-By September 23, 2010, all assurance plans must offer dependent coverage to children until age 26, regardless of marital status, learner status, or employment status.
-Tightly restricted every year limits on "Essential condition Benefits" are eliminated
-Waiting periods for pre-existing conditions are eliminated for children under age 19
-Lifetime benefits are eliminated
-35% tax reputation (immediate for 2010) for employers who offer and subsidize condition assurance for its employees.

Essential condition Benefits will be great defined by Hhs over time, but will authentically include mandatory wellness benefits. condition plans in effect on or before March 23, are carefully "grandfathered" and thus are exempt from the following mandates. However, a change in carriers, a "substantial" change in benefits, or a broad shift in costs of premiums to employees will effect in the loss of this exemption. Hhs will issue R & Rs later, supplementary defining the parameters of "substantial change".

Grandfathered plans may enjoy the luxury of smaller superior increases over time than non-grandfathered plans because these new plans have other, stricter requirements.

In the interim, grandfathered plans are exempt from:

-First dollar coverage for preventive care although some grandfathered plans offer this benefit.
-Non-discrimination rules are extended to assurance plans. That is, administration may not have a richer advantage plan than non-management
-Emergency care services must be treated as "in-network" without prior authorization
-Pediatricians and Ob-Gyns are carefully traditional care providers.

Insurance carriers will be required to abide by a "minimum loss ratio" (Mlr). This will apply to all group assurance plans. In short, the Mlr states that assurance clubs must issue refunds to groups if claims are less than 85% (large groups) and 80% (small groups) of total premiums paid. The reverse is also true. Small groups in particular could face excessively high premiums after one particularly unfavorable year. Some employers who supply condition assurance are now faced with some tough decisions as a effect of condition care reform. Non-grandfathered plans are more likely to see significantly higher premiums than grandfathered plans, as R & Rs construe some of the uncertainty.

Health Care Reform included some other obscure provisions about which employees are probably unaware. All non-grandfathered plans and owner groups with 25 or more employees (including common rights of 2 or more small businesses) will be subjected to a estimate of reporting requirements in addition to the mandates listed previously. Too, condition care reform will begin to count part-time employees as well through a recipe called "full-time equivalent" (Fte). This could be especially troubling to employers with fewer than 50 full-time employees, but after accounting for Fte of part-time employees they could inadvertently be counted as 50+ and field to mandates. The Fte recipe will be clarified as time goes by, but by January 1, 2014, all non-grandfathered groups will be field to these mandates.

Health care reform does not require employers to offer group insurance. Nevertheless, penalties will apply to 50+ laborer groups (including Fte & remember the common rights rule) who do not offer healing insurance. For instance, an owner would face a 00 fine per laborer (31st laborer and beyond) if even one laborer receives a 00 tax reputation from the government toward condition assurance through the change (to be explained in a later column) or through Medicaid.

Employers who offer condition assurance must also offer a free voucher, equal to the employer's contribution, to all employee's whose household income is less than 400% of the federal poverty level. The employers can then purchase assurance through the Exchange. If the change is economy than the value of the voucher, the owner is then required to pay the unlikeness to the employee.

On January 1, 2014, the Irs will get involved. Employers of 50+ and not grandfathered will be required to report the value of the condition assurance on W-2's to be issued by January 2012. Penalties will apply here as well if the reported value is greater than ,200 for individuals or ,500 for families. That is, insurers will be assessed an excise tax on the coverage and because of the Mlr, that assessment will likely be pushed on to employees as higher premiums.

If the employer's gift is less than 60% or the employee's cost share of superior exceeds 9.5% of household income and an laborer receives a government subsidy, then a penalty of ,000 for each laborer (31st laborer and beyond) is levied..

By March 2012, employers of 50+ and non-grandfathered plans must supply a 4-page pre-enrollment coverage document outlining benefits and exclusions to all new employees. Details will be forthcoming from Hhs.

Reading "between the lines", it would appear the government is making it difficult for employers at or near 50 full-time employees to offer condition insurance. Likewise, employers may be forced to eliminate part-time/seasonal workers and instead opt for overtime to regular/full-time employees to avoid inherent penalties and the possibility of having to cover part-time employees on insurance.

Health care reform includes other mandates that will trigger by January 1, 2014, but are not as likely as the above mandates to alter an employer's basic enterprise model on hiring practices, nor are they as apt to work on an employer's decision on whether to offer insurance.

Inevitably, many more questions will arise. As you can see, the intent with condition care reform is a push toward universal coverage through employers of 50+. Next time, we'll talk about individuals and groups under 50

health Care Reform - How Are You Affected? - Part 2

Sunday, March 27, 2011

Congressman Cohen on Fox about Health Care Reforms

Congressman Cohen on Fox about Health Care Reforms Tube. Duration : 4.32 Mins.

Congressman Cohen discusses the impact health care reform on tax subsidies and the economy with Neil Cavuto on Fox News.

Tags: Congressman, Steve, Cohen, Memphis, Tennessee, Obama, health, care, reform, stock, market, subsidies, Fox, News, Neil, Cavuto

Saturday, March 26, 2011

Conservative Group Decrys Health Care Reforms

Conservative Group Decrys Health Care Reforms Video Clips. Duration : 2.25 Mins.

The Red River Tea Party, a conservative issues group in Bossier City, Louisiana gathered on Aug, 20, 2009, to express disagreement with the President Obama's health care reform campaign and highlight issues that impede their vision of health care reform. Mario Villafuerte 2009

Keywords: Conservative, Bossier, City, Health, Care, Reform, Hispanics, Illegal, Aliens, Louisiana, Tea, Party, Medicine, Free, Speech, Mario, Villafuerte

Friday, March 25, 2011

condition Care Reform Pros And Cons

The condition care reform bill authored by the Congress has ultimately been approved. It is imperative that we know the pros and cons of this bill. Let us discuss some facts about this condition care legislation that should be common knowledge for every citizen.

The assurance clubs will be under the watchful eye of the government. The minimum services to be covered, such as preventive care, will be standardized. The premiums should have a single percentage to be paid out to patient care. The exchanges will be opened by the year 2014. By then, the assurance clubs will not be able to turn down clients because of the previous conditions.

Health Care Reforms

The hospitals or other secret condition care institutions won't be taken over by the government the way they do in Britain or Canada. Physicians won't be under the employment of the government such as in Britain.

condition Care Reform Pros And Cons

And unlike in Canada where all bills are paid by the government (single-payer system), the Us government will only aid individuals in buying assurance from secret companies. The other areas of the previous law such as Medicaid for the deprived, employer-assisted insurance, or Medicare for the aged will not be touched. For individuals who are compelled to get assurance on their own, the management will furnish exchanges for condition insurance. With this, they could comparatively analyze prices & plans with minimum effort.

Small clubs are not obliged to provide assurance for their employees but large clubs will be fined if they neglect to buy them insurance. Large clubs are those that employ fifty workers or more. For example, an employee for a enterprise of seventy workers purchases assurance on the exchange. Then it is found that he is eligible for the government's low-income reputation then the enterprise will be afforded a fine.

According to the personel mandate, every personel must have a condition assurance otherwise they will be fined. The intention of the government is to cap premiums for individuals who earn below a inescapable bracket. A minimum of 5 for every personel each year will include the fine. But there are exceptions like hardship on finances and other extra cases.

The Medicare program, which is controlled by the government, will continue shouldering the healing expenses for senior citizens. But cost controls will be implemented on condition care institutions, especially incentives & penalties. Medicaid will now cover all poverty-stricken individuals unlike before where only the elderly, disabled, children, or pregnant women are covered. Illegal immigrants aren't eligible for benefits. Nor does the government favor optional abortions except in cases of incest, rape, or when the mother's life was endangered.

condition Care Reform Pros And Cons

Thursday, March 24, 2011

condition Care Reform - Changes to Your condition Care as of September 23, 2010, Part 1

September 23, 2010 - another leading date for condition Care Reform. condition Care Reform is the latest media buzz, but it is still such a mystery for so many people. It is hard to understand what changes take place and when. And, it doesn't help that there are so many misconceptions floating around. So, let me elaborate the changes being made by condition Care Reform as of September 23, 2010.

Changes Already In Place

Health Care Reforms

0 Medicare Drug Cost Rebate In June, 2010, checks started being mailed out to an estimated 4 million senior citizens that have reached the "donut hole". The "donut hole" is the gap in Medicare designate drug coverage many seniors face when they hit a obvious age. Checks will continue to be mailed out monthly throughout 2010 as seniors hit the coverage gap. Small business Tax toll The first phase of this provision provides a reputation worth up to 35% of the employer's offering to the employee's condition insurance, and up to 25% for small non-profit organizations. Up to 4 million small businesses are eligible for these tax credits. It is designed to help them furnish insurance benefits to their workers. Expanding Coverage for Early Retirees On June 1, 2010, applications for employers to partake in this agenda became available. Americans that retire before they are eligible for Medicare and are without employer-sponsored insurance, are forced to pay high rates in the private market. They watch their life savings dwindle away. To help keep manager coverage for early retirees until more affordable coverage becomes available straight through the new Exchanges by 2014, the Affordable Care Act has created a billion agenda to furnish coverage to population who retire early, as well as their spouses and dependents. Early relinquishment is classified for these purposes as those that retire between the ages of 55 and 65. Get more information on the Early Retiree Reinsurance Program. Pre-Existing condition insurance Plans On July 1, 2010, the Pre-Existing condition insurance Plan was created to furnish new coverage options to individuals who have been uninsured for at least 6 months because of a pre-existing condition. Each state had the selection to run this new agenda in their state or have the branch of condition and Human Services manufacture a plan in that state. Allowing States to Cover More population on Medicaid efficient April 1, 2010, states are able to receive federal matching funds to cover some supplementary low-income individuals and families under Medicaid whom federal funds were not previously available. For states that pick to cover more of their residents, this will make it easier to do so. On January 1, 2014, the rest of this provision will go into place where it becomes mandatory that states furnish Medicaid to supplementary residents who wouldn't usually qualify. Cracking Down on condition Care Fraud Just while fiscal year 2009, .5 billion has been returned to the Medicare Trust Fund as a ensue of efforts to fight fraud. The Affordable Care Act invests new resources and requires new screening procedures for condition care providers to boost these fraud-fighting efforts and sell out fraud and waste in Medicare, Medicaid and Chip. Putting information for Consumers Online An easy-to-use website,, where consumers can assess condition insurance coverage options and pick the coverage that works for them became mandated on July 1, 2010.

condition Care Reform - Changes to Your condition Care as of September 23, 2010, Part 1

As you can see, we have already had any leading aspects of the condition Care Reform put in place. Some of these provisions are phase 1 of a agenda that spans over 4 years to complete. The most leading thing to remember is that currently, there is not a guaranteed issue plan or an exchange in which you can buy affordable insurance. Those changes don't come into ensue until 2014. Try to find a condition care plan that you can afford. To get any quotes where you can assess plans and prices for one that fits your needs and budget, sense an insurance branch that handles many insurance carriers.

condition Care Reform - Changes to Your condition Care as of September 23, 2010, Part 1

Wednesday, March 23, 2011

condition Care Reform, The Next Step

A vote to repeal in the House passes with some Democrat support. A federal judge declares the legislation unconstitutional. A vote to repeal the bill in the Senate goes along party lines and fails. What does this mean to the median American?

Clearly this political football will takes many strange bounces before the 2012 elections. And the outcome of the choosing may well decide how much if any of the condition care bill is indubitably implemented. Of course, the part of the equation that could have a dramatic consequent on the situation is what happens in the courts.

Health Care Reforms

With more than half the states engaged in law suits against the federal government, there will be more legal decisions arrival forth in the weeks and months ahead that could added damage the administrations efforts to save this controversial legislation and maybe derail it altogether.

condition Care Reform, The Next Step

As time goes on, the exceptions could overcome the rule. For instance, the fellowships requested waivers from participating has exploded from a handful at first to what could be a thousand or more. Unions have sought exemptions as well. Individuals have not been afforded this same opportunity. In fact, many secret policyholders will suffer because some Medicare advantage insurers have been forced out of business.

Health guarnatee rates continue to rise as guarnatee fellowships hope higher costs resulting from the plan's implementation. In addition, 32 million previously uninsured population will soon be covered and benefits must be paid on their behalf. Some 50% of the newly insured will be covered by Medicaid, which means private states pick up about half these costs. This in turn hurts financially strapped states and could raise taxes.

While there is a shortage of doctors in the United States, the medical profession is being asked to dispell more patients into the system. Yet, they are being asked to accept funding cuts in Medicare and Medicaid, which could lead to needful restrictions in the amount of these patients being seen and the care that is offered.

Fewer doctors are willing to accept Medicare and Medicaid patients. Those individuals wanting to keep their regular condition care supplier may be forced to pay for assistance out of their own pockets or switch doctors. And, there will be longer waiting periods to see specialists or to have tests performed. This may well be the first step in rationing.

The best that those receiving Medicare and Medicaid benefits can hope for is that the politicians fast-track the condition care case to the consummate Court and a decision concerning constitutionality bill is rendered. Politicians may want to do this in hopes that condition care won't be headline news going into the next election. For the median population such a ruling may expound the coverage situation. But, there will still be many unanswered questions, particularly how is this entitlement program going to be paid for and by whom.

condition Care Reform, The Next Step

Tuesday, March 22, 2011

health Care Reform Vs health assurance Reform

Health Care reform has been a hot item beginning prior to the most recent Presidential Election.  The Obama Administration, has now moved health Care Reform to the forefront of their agenda.  Regardless of your political affiliation, the unavoidable facts are that costs have continually increased over the last decade.  How should the problem(s) be resolved?

The average person who favors government intervention believes that the reform needed is with health Insurance.  Be faithful not to confuse health Care Reform with health assurance Reform.  The two issues should be completely different, but it seems the Obama administration has focused their energies in solving the health Care Issue by focusing on health Insurance.

Health Care Reforms

While there have been few specific plans for the administration's reform, many experts believe that the reform will involve a major involvement from the government.  While there are factions in this nation that favor a "Nationalized Health-care System", there is equal opposition.  Unfortunately, the collective divide seems to rest within the "class system".  A majority of those families and businesses in the upper-middle to upper class oppose a nationalized system, while the lower-middle to lower class favor a Nationalized Plan.

health Care Reform Vs health assurance Reform

I say to those that favor a Nationalized Plan, be wary of what you wish for!  The question with the divide honestly resides with schooling and communication.  Too often, those in the lower measure of the class law have been conditioned to believe the assurance associates are the big, bad behalf mongers that cause your premiums to increase.  Let's be frank, assurance associates are in business to make money.  However, if you take a look the behalf margins within most health assurance Carriers, you will see that most are lucky to achieve a 10% profit.

If the question with our the "System" is not with the health assurance Carriers, then where should the blame go?  Unfortunately, there is no one cause for the skyrocketing costs.  Rather, there are multitude of issues that have caused our health Care law to come to be the inefficient beast you see today.  There is no one "magic" pill that will fix our system.

If you take a step back and analyze our law as whole, you have to concur that we have the Best health Care Services in the world.  If this were not the case, then why would the world's wealthiest citizen fly colse to the world just to have their curative needs taken care in the United States?  The fact is, wealthy citizen who live in countries with Nationalized health Care Systems do not trust those health Care Providers with habit procedures, much less the more complex ones.

So if we can agree that the health Care Professionals and Facilities are the best in the world, then you should further assume that those individuals providing that care are deserving of anyone money they make.  For my part, I want the guy who is about to open my chest up to achieve heart surgery to be paid like a surgeon, and not a garbage man.  So how do we fix our system?

The first thing is to focus on the real problem.  The real question is with the inefficiencies present in the system, not with the assurance Industry.  There are cost savings available through the efficiencies that can be made through the use of technology.  By gaining the cost savings within the law itself, health Care Providers (not the actual Professionals) do not have to payment as much money.  That means the health assurance Carriers do not have to pay as much to the Providers.  Guess what!  That means the health assurance Carriers do not have to payment as much in premium.  Finally, Joe & Jackie Blow do not have to pay as much for health Insurance!

President Obama, focus on the real question of fixing our system, and health assurance Premiums will come to be more affordable.

health Care Reform Vs health assurance Reform

Monday, March 21, 2011

Obama's condition Care Reform Bill Vs The Workforce

Everyone can agree that condition care should be made ready to every American. Now that President Obama has signed the bill into law we have yet to view the whole package. Already burdened tax payers will pay dearly for this one as in the end we still pay the cost. Businesses will be required to supply condition coverage for employees. This activity will have anegative impact on the work force as small business will have to scramble for extra funds to pay for condition insurance. A small business owner will have 4 choices.

1) Raise the price of goods or services to compensate for the growth in costs. The end corollary consumers pay the price. Raising prices in a stepping back will slow sales which could lean toward layoffs adding more employees to the unemployment lines

Health Care Reforms

2) Force employees to pay a greater ration of the cost and opt for a economy course with less coverage. Employees will see less take home pay stretching already tight belts. With less to spend in their pockets we slide added into a depression.

Obama's condition Care Reform Bill Vs The Workforce

3) Lay off a few employees or ice hiring as employees retire to compensate costs. This activity will add workers to the unemployment lines sending us farther into a depression.

4) Start using temp agencies.

With a huge pool of overqualified work force in unemployment temps will be the wave of the future. An boss does not have to supply condition coverage for temporary employees. Every few months the boss will tell the division to send out separate workers so they do not have to hire anyone. Productivity and buyer aid will decline as a corollary of temporary workers. Although they can be good workers, a temporary work force will have to be retrained every few months as they are bounced nearby from workplace to workplace. After a period of time this can have physiological effects on the best of workers.

Introducing a precious condition care reform bill during a deep stepping back is bad politics. In the long run it might just push us into a depression. More job cuts and a added strain on the economy. The government all the time reports new unemployment filings for the month but they do not narrative the numbers whose unemployment benefits ran out and still are out of work. The government will not admit it because they all the time paint a rosy picture. Introducing the condition care bill during a deep stepping back took the focus off the economy to the new field of condition care reform.

Obama's condition Care Reform Bill Vs The Workforce