Medicare Watch

New Medicare Watch Feature: Health Reform Q&A

Do you have questions about health reform? We have answers. Amid the often contentious debate over the Affordable Care Act (ACA), it can be difficult to discern exactly how health reform will impact Medicare. That’s where we come in. If you have a health reform–related question, send it our way. In the coming weeks, we’ll choose some of your questions and answer them in Health Reform Q&A, a new feature in Medicare Watch. Who knows? Your question could be the first one we answer!

Click here to send us your questions.

In addition, we are still looking for personal stories related to health reform. If you are planning to make use of the annual wellness visit, or if you anticipate falling into the doughnut hole this year or if you have any other health reform–related story to tell, we want to hear from you.

Please tell us your story.

The Department of Health and Human Services (HHS) last week announced several important accomplishments related to the ACA:

• 3 million people with Medicare who fell into the doughnut hole last year have received assistance in the form of a $250 check. In 2011, people who reach the doughnut hole will receive a 50 percent discount on brand-name drugs.
• The government’s stepped-up efforts to fight fraud recovered a record $4 billion of taxpayer money in Fiscal Year 2010. The ACA includes new tools to help continue this effort and prevent fraud before it happens.

Read the HHS press release on assistance for Medicare consumers who hit the doughnut hole.

Read the HHS press release on the money recovered through anti-fraud efforts.

Brief Considers Medicare’s Coverage of Dual Eligibles

One of the most urgent health care policy questions is how to best cover and care for dual eligibles, people eligible for both Medicare and Medicaid. A brief released today by the Kaiser Family Foundation explores Medicare’s coverage of this population, how that coverage will change under the Affordable Care Act (ACA), and what the future looks like for dual eligibles. This population presents several distinct challenges. Dual eligibles are often in poor health, with multiple chronic conditions and mobility and cognitive issues, and as such account for a disproportionate level of health care spending. These consumers are also more likely to encounter care coordination issues because Medicare and Medicaid differ substantially in structure, systems and benefit design.

The ACA calls for the creation of two new offices to help tackle duals issues. The first, the Federal Coordinated Health Care Office (FCHCO) within the Centers for Medicare & Medicaid Services (CMS), aims to improve the coordination and integration of care between Medicare and Medicaid. The FCHCO will analyze expenditures, benefit design and health outcomes, and will communicate plans for improvement to consumers and providers. The second new office, the Center for Medicare and Medicaid Innovation (CMMI), is focused on designing, testing and implementing new models of health care delivery that will lead to lower costs and better care coordination and integration. The work of these offices will greatly impact the future of care for dual eligibles, as will the increasingly urgent political dialogue on deficit reduction.

Read the Kaiser Family Foundation’s brief.

Medicare Reminder

Starting in 2011, consumers who have Original Medicare will no longer pay coinsurance or a deductible for certain preventive care services recommended by the U.S. Preventive Services Task Force. Recommended services, which are 100 percent covered, include:

• diabetes screening
• medical nutritional therapy
• blood tests for heart disease
• bone mass measurement
• screening mammograms
• pap smears, pelvic exams and clinical breast exams
• colon cancer screening (fecal occult blood test, flexible sigmoidoscopy and colonoscopy)
• prostate cancer screening (PSA test)
• flu shot
• pneumonia vaccine
• hepatitis B vaccine
• annual wellness visit

Learn more about coverage of preventive services at www.MedicareInteractive.org.

Spotlight

The Medicare Rights Center issued a statement following the State of the Union address on Tuesday evening. In the statement, President Joe Baker urged Congress to work together on containing spending without harming people with Medicare.

Read the statement.