“Where Does the Money Go?” National Debt – Bill Moyers
Made BEFORE the current crisis, more scary now. Scott Bittle and Jean Johnson discuss their book, “Where Does the Money Go?” and the mounting debt and deficit of America. They offer an estimate of the time until the failure of Medicare and Social Security, and general suggestions to address this problem. See IOUSA the movie, visit the YouTube site www.youtube.com See also Health care reform, a look at successful systems of Taiwan and Switzerland, probably acceptable to US, and similar to some existing US models. www.youtube.com Farm Subsidies: Welfare To The Wealthy, Costs You Billions www.youtube.com WELFARE for the Wealthy, as US Poverty, Hunger Increase www.youtube.com Fall of Rome vs Failure of American Politics and Economy www.youtube.com PBS Bill Moyers’ personal take on Karl Rove www.youtube.com Iraq Cost Accounting, Bill Moyers www.youtube.com Earmarks, Washington Contributions, Corruption, Moyers pt1 www.youtube.com John McCain on earmarks www.youtube.com www.youtube.com Free Lunch, Corp Welfare, Bill Moyers and David Cay Johnston www.youtube.com John C. Bogel and Moyers, Capitalism and Democracy Pt 1 www.youtube.com 60 Minutes segment, third world charities providing healthcare for American working poor www.cbsnews.com Visit the PBS archives to see the complete show and more of Bill Moyers. www.pbs.org
Bill Corr – HHS Deputy Secretary
Bill Corr serves as Deputy Secretary of the Department of Health and Human Services. He was nominated by President Obama and confirmed by the Senate on May 6, 2009. Bill returned to the Department after serving as executive director of the Campaign for Tobacco-Free Kids, a privately funded organization established to focus the nations attention and action on reducing tobacco use among both kids and adults. More info at www.hhs.gov We accept comments according to our comment policy newmedia.hhs.gov US Department of Health & Human Services
Categories: Centers for medicare and medicaid services Tags: Bill, Corr, Deputy, Secretary
Obama Blames the GOP for Health Care Bill on “60 Minutes”
It figures. Obama blamed the Republicans for the fact that democrats rammed through their unpopular health care bill without a single Republican vote.
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NYC Public Advocate Bill deBlasio
The Public Advocate for New York City suggests that pension funds be used to pressure corporate changes: www.billdeblasio.com
Bill Gates’ Last Days… (Is it a Mac screensaver at 1:36, according to friedrichsacher?)
Sound fixed!!! Thanks to ZDNet, Kim Komando, w3sh, Houston’s KTRH, Today’s Big Thing, Start.no, ILovePolitics.info, 30metri, Satellite Sisters, RandomSyntax, ABCdane, MacBidouille, Leo Burnett, and The Beta News for the embedding! — The hilarious footage of Bill Gates’ last days before retirement, featuring cameos by Brian Williams, Steve Ballmer, Matthew McConaughey, Jay-Z, Bono, Steven Spielberg, George Clooney, Jon Stewart, Hillary Rodham Clinton, Barack Obama, and Al Gore… From the 2008 Consumer Electronics Show in Las Vegas, before his last keynote address. — video.msn.com Original uploader on MSN Video. Sound from another YouTube video… — Honours (Thank you everyone!!!): #13 – Most Linked (All Time) – Comedy – Canada #85 – Most Linked (All Time) – Canada — #28 – Most Linked (Today) #30 – Top Favorites (Today) #34 – Most Linked (This Week) #48 – Most Viewed (Today) #52 – Top Favorites (This Week) #59 – Most Viewed (This Week) — #1 – Most Viewed (This Week) – Canada #1 – Most Linked (This Week) – Canada #1 – Most Viewed (Today) – Canada #1 – Top Favorites (Today) – Canada #1 – Most Linked (Today) – Canada #1 – Most Linked (This Month) – Comedy – Canada #1 – Most Viewed (This Week) – Comedy – Canada #1 – Most Linked (This Week) – Comedy – Canada #1 – Most Viewed (Today) – Comedy – Canada #1 – Top Favorites (Today) – Comedy – Canada #1 – Most Linked (Today) – Comedy – Canada — #2 – Top Favorites (This Week) – Comedy – Canada #2 – Top Rated (Today) – Comedy …
Categories: Retirement Tags: according, Bill, Days, friedrichsacher, Gates', Last, screensaver
The New Healthcare Reform Bill Passed by Congress Prompts Expansion of Claims Recovery Company (CRC)
Rockford, IL (PRWEB) November 9, 2009
CRC, Claims Recovery Company, LLc, announced the expansion of its unique healthcare appeal services, following the House of Representatives passage the sweeping health care bill, H.R. 3962 representing the largest expansion of health care coverage since Medicare was created more than 40 years ago. President Obama said he was “absolutely confident” the Senate will follow suit in passing its version of the bill. Although turning the bill into law will see revision and Senate approval, it is now clear that claims regulations for reimbursement under this new federal law is based on ERISA and well settled from the bipartisan Bills. It will now be urgent for healthcare providers to take full advantage of ERISA regulation provisions.
“We have advocated since our inception, the use of federal ERISA law to resolve payment disputes with hospitals. We are thrilled that Congress agrees with us and hope that the Senate will too” Says F. Scott Winslow, CEO of the two year old CRC. “CRC has been utilizing the thirty four year old ERISA law and its claim regulations providing for a ‘full and fair review’ with a properly formatted, properly submitted ERISA appeal for its hospital clients from coast to coast.”
Although it is currently uncertain what final provisions will be signed into law, the antitrust provisions of H. R. 3962 represent a sweeping opportunity for health providers to “level the playing field with the insurance industry through the new laws use of ERISA 29 CFR 2560.503-1, and equal anti-trust provisions for both insurers and providers for the first time. ERISA will be statutorily incorporated in its entirety into the new law for all qualified health benefit plans (QHBP), as the most important provisions from H. R. 3962 for healthcare providers for reimbursement purposes. The Affordable Health Care for America Act will create a new federal agency, Health Choices Administration, regulating qualified health benefit plans (QHBP), consisting of employment-based health plans, the traditional voluntary ERISA plans, and health insurance exchange plan, the new mandatory ERISA plans. The new legislation, H.R. 3962, is significant to CRC in following provisions:
1. Sec. 232 (b) of the Act, Requiring Fair Grievance and Appeals Mechanisms of the Act provides: “(b) INTERNAL CLAIMS AND APPEALS PROCESS.–Under a qualified health benefits plan the QHBP offering entity shall provide an internal claims and appeals process that initially incorporates the claims and appeals procedures (including urgent claims) set forth at section 2560.503-1 of title 29, Code of Federal Regulations, as published on November 21, 2000 (65 Fed. Reg. 70246) and shall update such process in accordance with any standards that the Commissioner may establish”. CRC is expert in this area and currently offers this service to existing clients.
2. Sec. 232 (c) of the Act also creates a new federal external review process based on ERISA claim regulation to provide for an impartial, independent, and de novo review of denied claims, and the Health Choices Commissioner’s decision shall be binding on the plan and the entity, as the final claim decision in absence of judicial review, which will now be available for punitive damages for exchange participating health plans. CRC foresees an extended ability to assist clients as it has prepared files for this process since its inception under the existing regulation process.
3. Sec. 233 of the Act, Requiring Information Transparency and Plan Disclosure, enhanced the existing ERISA disclosure obligations for the plan and insurance company, and requires “Accurate and Timely Disclosure”, for both exchange participating health benefit plans and employment-based health plans, to both the Health Choices Commissioner and the public, doctors, hospitals and the patients, of plan documents, plan terms and conditions, claims payment policies, and practices, periodic financial disclosure, data on the number of claims denials, data on rating practices, information on cost-sharing and payments with respect to any out-of-network coverage, and other information. CRC expects a more timely compliance with its ERISA based appeals and document reviews under this section of a new law.
4. Sec. 233 (5) of the Act, Cost-Sharing Transparency, requires the plan to disclose to the healthcare provider the real fee schedule, plan UCR limit for individual service and supplies at CPT & HCPCS code level. CRC foresees a distinct advantage in resolving its appeals on behalf of its clients the UCR provisions have been the most tightly held secrets of the insurance industry and subject to actions by attorneys’ general.
5. Sec. 235 of the Act, Timely Payment of Claims, provides new federal “Prompt Pay” laws, based on Medicare Part C timeframe, Managed-Care Medicare, to comply with the requirements of section 1857(f) of the Social Security Act.
6. Sec. 238 of the Act, State Prohibitions on Discrimination against Health Care Providers, has adopted “Any Willing Provider Laws” from existing state laws. CRC sees a great advantage to it’s out of network clients and predicts a new era of contracting with insurance companies for its hospital clients if this provision is written into the final version of the law.
7. Sec. 251 of the Act provides new consumer protections, with state law compensatory and punitive damages as remedies for exchange-participating health plan members. Although the new law does not change the status of ERISA preemption as desired by the insurance industry, state punitive damage remedies for employment-based health plans (traditional ERISA plans) will remain in effect.
8. Sec. 257 of the Act allows state attorney general to sue for the compensatory and punitive damages on behalf of the private citizen of the state for any violations by the exchange-participating health plans, although traditional ERISA plans are still immune from state government actions from insurance Commissioners or attorneys general.
9. Sec. 262 of the Act, Restoring Application of Antitrust Laws to Health Sector Insurers, if signed into law, this will cripple the existing managed care practice model and in conjunction with vigorous enforcement of the new provision for federal ERISA claim regulations, complete disclosure of plan information and fee schedules will now be mandatory under a proper ERISA appeal.
The Affordable Health Care for America Act is 1990 pages long. For more information and relevant documents, please visit the Website of House Of Representatives:
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687&catid=156&Itemid=55
CRC offers, as an outside service, a process to appeal bad debt insurance claims (up to six years old) under federal ERISA law as a patient advocate. This has the potential to deliver substantial portions of the contractuals for any claim where the commercial insurance coverage was issued by an employer (government, church and a few other minor categories are accepted). CRC performs this “administrative appeal” process with no upfront fees and is paid a percentage of new payments delivered directly to the hospital. CRC’s staff performs all work and answers all correspondence. CRC’s approach has been utilized by hospitals and other providers for over ten years and they have clients from California to New York.
For more information or to arrange an interview, please visit www.crcclaim.com , or contact Mr. F. Scott Winslow, CEO at 815-397-8002.
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View full post on Social Security Network
Categories: Social Security Tags: Bill, claims, Company, Congress, expansion, Healthcare, Passed, Prompts, Recovery, Reform
Health bill could raise Oklahoma?s costs
The health insurance reform bill approved by the House on Nov. 7 could add more than 318,000 Oklahomans to the state’s Medicaid program and cost the state $128 million more each year, according to estimates from the state authority that administers the health care program for the poor.
“It will have a cost at a very tough time from a revenue standpoint in being able to afford it,” said Nico Gomez, deputy chief executive officer at the Oklahoma Health Care Authority.
Gomez said the Health Care Authority has been trying to estimate the potential impact of various congressional proposals on health care; state legislative leaders and members of Congress have been seeking the estimates because of the major expansion of Medicaid envisioned in both the House and Senate bills.
Medicaid is a federal-state health care program that, in Oklahoma, covers primarily pregnant women and children.
But the House bill would use the program to greatly reduce the ranks of the uninsured nationwide, making everyone eligible whose income was 150 percent or less of the federal poverty level (about $33,000 per year for a family of four.)
The federal government pays an average of 57 percent for Medicaid care and states pick up the rest. The House bill says the federal government would pay an average of 91 percent for the new people added, at a cost of about $425 billion over 10 years. According to the Congressional Budget Office, states would have to come up with about $34 billion over the 10-year life of the bill.
The biggest set of people who would become newly eligible if the House bill were to become law are adults between the ages of 19 and 65 whose income is below 150 percent of the poverty level. According to the Health Care Authority, there are 219,000 Oklahomans in that category.
There are already about 57,000 children in Oklahoma who qualify for Medicaid under the federal Children’s Health Insurance Program but aren’t currently participating, and there are thousands of other low-income Oklahomans who have private insurance but are counted as eligible because Medicaid would be a payer of last resort.
Oklahoma House Speaker Chris Benge said earlier this month that, given Oklahoma’s current fiscal woes, the $128 million in additional Medicaid spending “would lead to further budget cuts, jeopardizing existing state programs and services developed for Oklahomans by Oklahomans.”
Benge said the state is using market- and consumer-driven reforms to move the state’s uninsured into private insurance.
State is among worst in uninsured
However, according to the latest Census Bureau estimates, more than 18 percent of Oklahomans didn’t have health insurance in 2007. That’s among the top 10 uninsured rates in the country.
U.S. Reps. Mary Fallin, R-Oklahoma City, and Tom Cole, R-Moore, said the House bill would put pressure on states at the worst possible time.
“Increasing access to health care for the uninsured and underinsured is an important undertaking, but we cannot do so at the expense of the fiscal stability of states,” Fallin said.
Because Oklahoma is not a wealthy state, Gomez said, the Medicaid expansion mandated in the House bill will make a lot of people eligible, including young working men and women.
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Categories: Eligibility for medicaid Tags: Bill, Costs, Could, Health, Oklahoma's, raise
Affordable Health Insurance Funding in Spending Bill, But What About Deficits?
Affordable Health Insurance Funding in Spending Bill, But What About Deficits?
While the healthcare reform bill is getting most of the attention, a massive general spending bill that was recently passed by Congress deserves some as well. The budget legislation includes defense appropriations, funding for jobs, and other elements. It also increased funding in several health-related areas. These funds may indirectly result in more affordable health insurance.
Which health agencies and programs saw their budgets increase in the bill?
*
The Veteran’s Health Administration, which provides affordable health insurance and medical care to armed forces veterans, had its budget increased by .1 billion for the 2010 budget year, to just over billion.
* Medicare and Medicaid, among other federal benefit programs, received 0 billion in mandatory payments within the bill. This does not include any possible costs that would result from allowing individuals between the ages of 55 and 64 to buy into the former. The expenses of the government-run affordable health insurance option for seniors could potentially explode if millions more Americans were added to the rolls, even though the extension of benefits would not be a pure entitlement. Despite the healthcare reform compromise proposal requiring that middle-aged individuals in that age range pay health insurance premiums into the system, detractors still predict that the cost of covering their medical expenses will outweigh their premium payments. There are already fears of looming bankruptcy ahead for Medicare, and that wouldn’t help. As for Medicaid, the affordable health insurance program for the poor will probably see its usage decrease if healthcare reform passes and the included subsidies assist individuals and families on the higher end of the Medicaid eligibility scale in buying health insurance. However, any such changes would not take effect for several years.
* The annual budget of the National Institute of Health–one of the U.S.’s premier medical research centers–was increased by about 0 million. Its budget now stands at billion. On the one hand, more funding for the NIH will result in medical innovations that are effective and can save time and money for insurers, doctors, hospitals, and patients; that would make affordable health insurance more widely available. Unfortunately, some discoveries will be amazingly beneficial but expensive: health insurance premiums will then be more expensive for the plans which choose to cover them.
* Various federal programs, including those relating to health, under direct congressional control will have their budgets increased by 10% in the recently passed bill. One of the affordable health insurance programs impacted may be the State Children’s Health Insurance Plan (SCHIP). The plan is generally popular with legislators, as well as the public; it is far less controversial than the healthcare reform bills meant to cover adults.
The price tag of this congressional spending bill is daunting. The version passed by the Senate for the 2010 budget year–which began on October 1st–costs .1 trillion. Even scarier to deficit hawks is the provision in the bill that would allow the federal government to, in effect, increase its credit limit. The maximum national debt the government is legally allowed to borrow will rise to trillion from the current .1 trillion; and to think, on the eve of a new decade, that we entered this one with a national budget surplus! Such a change is being pushed for by Democrats, although politicians from both parties are understandably wary of adding nearly trillion of healthcare reform legislation on top of that. Predictably, most Democrats voted in favor of the budget appropriations bill, while the majority of Republicans voted against it. Some members of President Obama’s own party, however, are urging a so-called “pay-as-you-go” law that would prevent new federal spending allocations or tax cuts to go forward unless plans are presented that would pay for them and ensure that they do not add to the national deficit. With many legislators loathe to approve tax increases on any population or category on spending, such a rule would put the Democrats’ attempt at providing affordable health insurance to more of the American population in peril. In addition, there has been bipartisan support for the formation of a deficit reduction task force.
Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they can find affordable health insurance right now while waiting for a public option, if it ever gets passed. Yamileth lives in Miami, FL.
Categories: Uncategorized Tags: about, Affordable, Bill, Deficits, Funding, Health, Insurance, Spending
Big Gov’t Forces Health Care Bill Despite Bi-partisan Opposition
www.infowars.com IN A SPECIAL NEWS BULLETIN, Alex Jones warns against the Big Government, Big Insurance Health Care Bill being forced down in the Senate despite opposition by members in both parties and an overwhelming majority of Americans. After all the denial, the final version of the bill proves to have in place the so-called death panels, the abortion funding, no public option, cuts in Medicare and forced coverage backed by heavy fines or prison. Outrageously, Senator Reid & co. have added a section to the bill, Section 3403, that prevents any future Congress from changing the Medicare Advisory Boards (ie the ‘death panels’). Section 3403 reads “it shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.” Watch the video for Alex’s full analysis. For more info: Bleak Deficit Numbers Projected Under Obama’s Budget Plan www.pbs.org Poll: Public Disapproval of ‘Obamacare’ Jumps to 52 Percent www.foxnews.com Obamacare: Nightmare before Christmas savannahnow.com Obama’s trillions dwarf Bush’s ‘dangerous’ spending www.washingtonexaminer.com Obama Shatters Spending Record for First-Year Presidents www.foxnews.com ObamaCare Keeps Falling in the Polls online.wsj.com Health Care Bill Is A Huge Tax Heist www.prisonplanet.com Under ObamaCare, Prepare To Wait 18 Months To See A Doctor www.prisonplanet.com Polls: Majority Disapprove of Health Care …
Categories: Medicare Tags: Bill, Bipartisan, Care, Despite, Forces, Govt., Health, opposition
Health bill could hurt Delaware
Before health care reform dominated debate on Capitol Hill, Delaware and several other states worked aggressively to increase the number of low-income residents covered by Medicaid, the federal-state insurance program for the poor.Now, those efforts could hurt them, sticking them with an uneven share of the bill for expanding Medicaid under one reform proposal.
The health care bill the Senate Finance Committee approved last month would expand Medicaid coverage to people earning up to 133 percent of the federal poverty level. But states such as Delaware that already have significantly increased eligibility for Medicaid would get less financial help from the federal government than states that haven’t.
Under the Finance Committee bill, “expansion states” that already cover people earning at least 100 percent of the poverty level ($22,050 for a family of four), would start off in 2014 getting 10 percent less in federal assistance than other states. The differential would narrow over five years and disappear in 2019.
The 18,000 new Medicaid recipients would cost the state an additional $21 million in fiscal 2014, according to state estimates.
At a time when state governments are facing budget shortfalls, some say their states shouldn’t be penalized for being progressive.
“We feel it’s unfair to the states that have really gone out on a limb and expanded Medicaid coverage to more individuals,” said Rosanne Mahaney, acting director of the Delaware Division of Medicaid and Medical Assistance. “It’s almost punishing the states that have gone beyond what’s required.”
The other expansion states are Arizona, Hawaii, Maine, Maryland, Massachusetts, Minnesota, New York, Pennsylvania, Vermont, Washington, Wisconsin and the District of Columbia, according to the Finance Committee.
House bill different
Delaware would fare better under the health care bill the House passed Nov. 7. That bill would expand Medicaid eligibility to people earning up to 150 percent of the poverty level and would treat states equally in terms of federal matching payments. Those payments would cover 100 percent of expanding Medicaid eligibility in 2013 and 2014 and would cover 91 percent of expansion costs beginning in 2015.Under the House plan, the state wouldn’t have to spend anything to cover an additional 24,364 Medicaid recipients for the first two years. It would spend about $11.8 million a year beginning in 2015, according to preliminary estimates.In addition, many of the childless adults that Delaware made eligible for Medicaid as part of its 1996 expansionwould be treated as newly eligible under the House bill. That means the federal government would pick up all of those costs in 2013 and 2014 — saving the state more than $175 million each year — and 91 percent beginning in 2015. That would not be the case under the Senate bill.
Rep. Mike Castle, R-Del., voted against the House bill, citing other reasons, including its cost.
Sen. Tom Carper, a member of the Finance Committee, voted to pass the bill Oct. 13. Though the Delaware Democrat worked extensively on shaping the legislation, he did not propose an amendment to address what he now describes as “a basic inequity.”
“I don’t think it was on my radar screen,” he said Friday.
Meeting with Reid
However, he and Sen. Ted Kaufman, D-Del., were among 11 senators from expansion states who met recently with Senate Majority Leader Harry Reid of Nevada to seek some form of parity in whatever health care reform bill comes to the Senate floor, possibly this month.
But he acknowledged that increasing the federal match for expansion states would make it harder to pay for the health care reform bill.
“I don’t expect that our states will be made whole, but we would certainly appreciate some kind of action that recognizes our early contribution,” Carper said.
The meeting followed an Oct. 22 letter that 14 senators, including Carper and Kaufman, sent to Reid and two key committee chairmen asking for a boost in federal matching funds.
Reid’s home state of Nevada and three others — Michigan, Rhode Island and Oregon — would fare well under the Finance Committee bill because of a deal Reid said he struck with the committee’s chairman, Sen. Max Baucus of Montana.Those states would qualify for full federal funding for new Medicaid recipients for five years because they have lower-than-average Medicaid enrollment and unemployment of at least 12 percent.”The people of Nevada are hurting, and I make absolutely no apologies, none, for helping people in my state and our nation who are hurting the most,” Reid said on the Senate floor in September.
Delaware typically spends more than $500 million annually on medical assistance, according to Mahaney. The vast majority of the 170,000 people receiving assistance are on Medicaid.
In its biggest expansion of Medicaid, Delaware began covering childless uninsured adults earning up to 100 percent of the federal poverty level in 1996, according to Mahaney. Other groups earning 100 percent of the poverty level or above are also covered.
Generally, the federal government matches half the cost of Medicaid in Delaware.
Mahaney said Delaware and other expansion states want the same increase in federal funds that other states would get under congressional health care reform legislation.
“We don’t think we should be punished because we’re more advanced in covering more people under Medicaid than some of the other states,” she said.
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