Hospitals are eligible for increases in reimbursement based on quality indicators.
Look for efforts to allow the federal government to negotiate prices, medigap policy reform and glitches that are discovered that disadvantage individuals eligible for state-based supplemental programs as initial targets for reform.
8 percent of Medicare-only eligibles had diabetes, 25.
Both the dually eligible population and Medicare-only eligibles displayed statistically significant decreases in PCS and MCS scores between baseline and remeasurement (1999-2001) as shown in Table 2.
For low-income, dual eligible
seniors, Senior Whole Health is the gold standard for addressing the current fragmentation of care delivery systems, with one entity streamlining the coordination of all facets of well being - clinical, functional, psychosocial and long term.
In March 2005, three insurance subsidiaries of Universal American applied to the Centers for Medicare and Medicaid Services ("CMS") to become a Prescription Drug Plan sponsor ("PDP") in 32 of the 34 regions designated by CMS (excluding Regions 33 (Hawaii) and 34 (Alaska)), thereby becoming eligible, upon final approval by CMS, to offer the Medicare-approved plans in those regions.
There are more than 30 million Medicare beneficiaries who will not be automatically assigned to PDP's and are eligible to buy this coverage voluntarily.
Medicare eligible Californians with both Parts A and B of Medicare may apply for the SmartValue plan as long as they reside in one of the four counties where it has been approved.
Headquartered in Southern California, Blue Cross of California offers a flexible product portfolio with a broad range of options for small, medium and large groups, as well as individual plans for people without access to group coverage, seniors and consumers who are eligible for state sponsored programs.
For example, according to the MMA Benchmark Series, in 2004 over 54% of Part D eligible Medicare patients taking a proton pump inhibitor entered the "doughnut hole" and therefore would have been required to pay 100% of the drug cost during this period.
Clients who understand how Part D eligible patients are currently utilizing their drugs will be better prepared to deal with the impact of the law once enacted.
Figure 1 shows the mean Medicaid payments per dually and non-dually eligible
enrollees for FFY 2002.