Monterey, CA Medicare Elder Abuse Alert

An old woman talking on a phone.


There is never a shortage of elder abuse scams making the rounds, but the latest to hit our area is Medicare related.  You will receive a message that says “Hi, this is Becky, your patient advocate working closely with Medicare.  Currently, Medicare is offering precautionary genetic cancer screening nationwide and has recommended that anyone over the age of 50 be tested.  These tests help to detect early signs of cancer and are covered by your insurance.  If you do not act soon, Medicare may label you as ineligible for coverage.  Please press 1 to speak to a specialist.â€Â  The situation is so dire that AARP The Magazine (August/September Issue, Page 32) ran a two-page story on it.  Do not fall for this scam!  If you have any questions, call the AARP Fraud Watch Network’s helpline at 877-908-3360.

Medicare Insurers Took $9.2 Billion In Federal Payments In One Year Via Controversial Billing Practices : By Derek Baine

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There seems to be no end to the tricks insurers will come up with in order to suck more money out of Medicare.  According to the findings of the Office of Inspector General of the Department of Health and Human Services, it analyzed 20 companies and investigators found that one received about 40% of the questionable payments, or $3.7 billion, while enrolling only 22% of Medicare Advantage customers.  It wouldn’t name the company, but BMO Capital Market looked at federal data and showed that the enrollment share closely matches UnitedHealth Group Inc. during the period the investors looked at.

https://www.wsj.com/articles/most-of-9-2-billion-in-questionable-medicare-payments-went-to-20-insurers-federal-investigators-say-11632303001

Pebble Beach, CA Telemedicine Is Here To Stay, Says Medicare

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More than three times as many Medicare beneficiaries had access to their doctors via a phone or video visit during the pandemic than before, a trend which is likely to continue with the new COVID-19 variant causing another surge in coronavirus cases.  The Kaiser Foundation, which recently conducted a study on this issue, said that expanded telehealth care is really good news for people of color, those with disabilities and low income families.   Those living in rural areas had difficulty getting to the doctor even before coronavirus.  Believe it or not, Monterey County is considered rural and indeed in South and North County populations are spread out over quite a large footprint. Thankfully, in early 2020, Medicare expanded coverage of such visits to enable all enrollees to keep up with their medical care while minimizing their r4isk of exposure to the coronavirus.  Although the rules only extend through the end of 2021, there are a number of bills in Congress which would make telehealth coverage permanent.

https://www.aarp.org/health/medicare-insurance/info-2021/telehealth-increase-covid-pandemic.html

AARP Urges You To Fight For Lower Prescription Prices

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The American Association for Retired Persons, or AARP, has launched a campaign #ShowYourReceipts to put pressure on Congress to lower drug prices.  Americans pay the highest prescription drug prices in the world!  Here is how you can participate:

  1. Take a copy of your prescription invoices;
  2. Tag your federal law makers; and
  3. Add #ShowYourRecipts to your post.

Health & Human Services Secretary Announces Plan To Reduce Prescription Drug Prices

A table with many different types of pills on it.


Health & Human Services Secretary Xavier Becerra outlined the Biden Administration’s plan to reduce the cost of prescription drugs.  The 29-page plan supports legislation that allows the federal government to negotiate lower drug prices on the costliest drugs each year, and pass those savings on to insurers.  It would also reduce regulatory barriers in order to get new drugs approved by the FDA and incentivize drug makers to develop medications that are already on the market in the U.S. in order to reduce prices.  Per-capita prescription drug spending in the U.S. far exceeds that of other high-income countries.

https://www.cnbc.com/2021/09/09/biden-administration-unveils-plans-to-lower-prescription-drug-costs-in-the-us.html

Medicare Could Soon Cover Dental And Eye Care

A nurse is smiling next to an older woman.


As part of a large budget bill making its way through Congress, there is a provision to provide dental and eye care for Medicare recipients for the first time in our nation’s history.  Ironically, the bill is facing opposition from dentists, who fear that government reimbursement rates would be too low.  Back in 1965, the American Dental Association fought to keep dental from being a paid service for Medicare recipients.  Sadly, nearly half of all Americans over the age of 65 did not visit a dentist last year, and almost 20% have lost all of their teeth.  I know about the problem firsthand.  In addition to owning Family inHome Caregiving, I am president of the non-profit Hands to Help Seniors which provides emergency assistance to seniors in a financial pickle.  The vast majority of our donations go to providing dental care to low-income senior citizens, which is very expensive.

https://www.nytimes.com/2021/08/29/upshot/medicare-dental-care.html

Pacific Grove, CA Telemedicine Is Here To Stay, Says Medicare

A person holding a stethoscope in front of a laptop.


More than three times as many Medicare beneficiaries had access to their doctors via a phone or video visit during the pandemic than before, a trend which is likely to continue with the new COVID-19 variant causing another surge in coronavirus cases.  The Kaiser Foundation, which recently conducted a study on this issue, said that expanded telehealth care is really good news for people of color, those with disabilities and low income families.   Those living in rural areas had difficulty getting to the doctor e//ven before coronavirus.  Believe it or not, Monterey County is considered rural and indeed in South and North County populations are spread out over quite a large footprint. Thankfully, in early 2020, Medicare expanded coverage of such visits to enable all enrollees to keep up with their medical care while minimizing their r4isk of exposure to the coronavirus.  Although the rules only extend through the end of 2021, there are a number of bills in Congress which would make telehealth coverage permanent.

 

https://www.aarp.org/health/medicare-insurance/info-2021/telehealth-increase-covid-pandemic.html

TRUST Act Working Its Way Through Congress Could Cut Medicare And Social Security

A building with the capitol in the background.


A very unpopular bill called The Time to Rescue United States Trusts (TRUST) Act is now working its way through Congress.  If passed, it would set up groups of a dozen lawmakers with the power to recommend cuts to Social Security and Medicare.  This would hit the most vulnerable.  Half of those covered by Medicare have incomes of less than $27K.  Social Security is the main source of income for more than 34 million older households.  Under the new law, if seven of the twelve committee members approve of changes, they would be fast tracked in both the House of Representatives and the Senate, with no adequate debate among lawmakers and no amendments permitted on the floor of the House or the Senate.  To make sure that your senators and representative know you oppose the TRUST Act, please go to  https://action.aarp.org/trustact.

Biden Lays Out Plan To Cut Drug Prices


President Joe Biden recently signed an executive order that aims at lowering drug prices, and it actually has teeth.  One provision is that the government can now take legal action against companies that collude to try and keep generic drugs from coming to market.  Another allows states and Indian tribes to import drugs from Canada.  He also directed the FDA’s parent agency, the Department of Health and Human Services, to issue proposed rules within 120 days to allow hearing aides to be sold over the counter.  The four largest makers of hearing aides control 84% of the market.  Because they are so expensive, only 14% of the 48 million Americans suffering from hearing loss use the devices.  Still, some criticized the order because it doesn’t give Medicare the power to directly negotiate prices with drug companies.  “Negotiation of prices is the biggest and best solution,†to lowering drug prices, said Diana Zuckerman, president of the National Center for Health Research, a nonprofit based in Washington D.C.

Housing Developer Invests In CareMax Inc.

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One of the largest owners of affordable housing in the U.S., Related Cos., is acquiring a 9% stake in healthcare provider CareMax Inc. as part of a plan to develop a number of senior health care centers in underserved urban communities across the country.  In addition, Related will act as an investor, adviser, developer and in some cases landlord for CareMax health centers.  They are currently only located in Florida, however, have announced plans to expand into California, Ohio, New York and Texas.

https://www.wsj.com/articles/related-cos-caremax-partner-up-to-develop-senior-health-centers-in-underserved-communities-11626168602