Medicare CMS Posts
Medicare Advantage Provider to Pay $30 Million to Settle Alleged Overpayment of Medicare Advantage Funds | OPA | Department of Justice
Michigan: Complaint filed against Sonic Drive-in Owner for Defrauding Medicare and Medicaid to the Tune of $1.2 Million
by Stuart.Zang@cms.hhs.gov on April 9, 2019 at 4:00 am
Think before you drink
As you get older, alcohol may start to effect you differently. You may become more sensitive to it, and your regular drinking habits could become a problem. Alcohol can also cause dangerous interactions when mixed with prescription or over-the-counter medications. Drinking too much can cause falls and fractures and can lead to some cancers, liver and brain damage, osteoporosis, and strokes.
Medicare covers alcohol misuse screening & counseling to provide counseling for people who misuse alcohol. The National Institute on Alcohol Abuse and Alcoholism recommends adults 65 and over who are healthy and don’t take medications have no more than 3 drinks on a given day or 7 drinks in a week.
If you think you or a loved one could be misusing alcohol, don’t be ashamed to ask for help. April is Alcohol Awareness Month, and Medicare wants to help you stay safe and healthy.
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Tue, 04/09/2019 – 04:00 […]
by Stuart.Zang@cms.hhs.gov on March 28, 2019 at 4:01 am
Using opioids safely
Doctors may prescribe opioids, a class of drugs used to treat pain, after surgery or an injury. Although opioids can be an important part of treatment, they have serious risks like addiction, abuse, and overdose, especially if used continuously.
That’s why Medicare is working with doctors and pharmacists to perform safety checks to help you use opioids safely. Medicare is also using new drug management programs to look for potentially high-risk opioid use.
These checks and programs generally won’t apply to you if you have cancer, are in hospice, get palliative or end-of-life care, or if you live in a long-term care facility.
Safety checks at the pharmacy
When a prescription is filled at the pharmacy, your Medicare drug plan performs additional safety checks and may send your pharmacy an alert to monitor the safe use of opioids and certain other medications.
These safety checks may cover situations like possible unsafe amounts of opioids, first prescription fills for opioids, or use of opioids at the same time with benzodiazepines (commonly used for anxiety and sleep). If your pharmacy can’t fill your prescription as written, the pharmacist will give you a notice explaining how you or your doctor can call or write to your plan to ask for a coverage decision. Visit the Medicare drug plan coverage rules page for more information about safety checks.
Drug management programs
As of January 1, 2019, some Medicare drug plans have a drug management program in place to help you use opioids safely. If you get opioids from multiple doctors or pharmacies, your drug plan may talk with your doctors to make sure you need these medications and are using them safely and appropriately.
Safety checks and drug management programs are just some of the ways that Medicare, Medicare drug plans, and pharmacies are working together to make sure you’re getting the pain relief treatment you need while keeping you safe. Read your Medicare drug plan’s materials for more information on their specific drug coverage rules.
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Thu, 03/28/2019 – 04:01 […]
by Stuart.Zang@cms.hhs.gov on March 26, 2019 at 4:01 am
Know your diabetes risk—take this quick test!
One in three Americans is at risk for developing type 2 diabetes, a serious disease that can lead to complications like kidney disease, blindness, and amputations. But type 2 diabetes doesn’t have to be permanent– you can delay or even prevent it with healthy lifestyle changes. Many people with diabetes don’t know that they have it, but Medicare covers screening tests so you can find out if you do.
Tuesday, March 26 is American Diabetes Association Alert Day, a day that focuses on the seriousness of diabetes and the importance of understanding your risk. It’s also a great time to take the Diabetes Risk Test to find out if you’re at risk for developing type 2 diabetes. Knowing your risk is the first step. Type 2 diabetes develops most often in middle-aged and older adults.
If you have diabetes, Medicare covers many of your supplies, including insulin, test strips, monitors, lancets and control solutions. In some cases, Medicare also covers therapeutic shoes if you have diabetic foot problems. You pay 20% of the Medicare-approved amount for these supplies.
Medicare also covers diabetes self-management training to help you learn how to better manage your diabetes. You can learn how to monitor your blood sugar, control your diet, exercise, and manage your prescriptions. Talk to your doctor about how this training can help you stay healthy and avoid serious complications.
Take control of your health—talk to your doctor today about which screening tests, supplies, and training may help you stay healthy.
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Tue, 03/26/2019 – 04:01 […]
by Stuart.Zang@cms.hhs.gov on March 22, 2019 at 12:00 am
Need help with your Medicare costs?
If you have Medicare and you’re facing challenges with paying for health care, you may qualify for programs that can help you save money on medical and drug costs.
People with limited income and resources may qualify for Medicaid, a joint federal and state program that helps with medical costs.
Even if you don’t qualify for Medicaid, one of these 4 Medicare Savings Programs may be able to help you pay your Medicare premiums and other costs:
Qualified Medicare Beneficiary (QMB) Program
Specified Low-Income Medicare Beneficiary (SLMB) Program
Qualifying Individual (QI) Program
Qualified Disabled and Working Individuals (QDWI) Program
If you qualify for Medicaid or one of the Medicare Savings Programs above, you’ll also get Extra Help paying for your prescription drugs automatically. Extra Help is a Medicare program that helps people with limited income or resources pay Medicare prescription drug costs, like premiums, deductibles and coinsurance. If you don’t automatically qualify for Extra Help, you can apply online at SSA.gov.
Even if your income or resources are higher than the amounts listed on Medicare.gov, call or fill out an application if you think you could qualify for savings. These amounts change yearly, and you may be eligible for another savings program, depending on your situation. To find out if you’re eligible for savings through one of these programs, call your state Medicaid program. Also, watch our video to find out more ways you can save money on your Medicare coverage.
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Fri, 03/22/2019 – 00:00 […]
by Stuart.Zang@cms.hhs.gov on March 15, 2019 at 12:00 am
Knowledge is power when it comes to kidney health
Did you know that approximately 90% of people with kidney disease don’t even know they have it? The best treatment is early detection when kidney disease can be slowed or stopped. But, if you’ve already been diagnosed, Medicare is here to help you make informed decisions about your care.
If you have Stage IV chronic kidney disease, Medicare covers up to 6 kidney disease education sessions that teach you how to take the best possible care of your kidneys. Sessions include topics like how to prevent complications of kidney disease, what to eat and drink, and what options you have if your kidneys get worse, like dialysis and kidney transplants.
If you or a loved one has advanced kidney disease requiring dialysis, often known as End-stage Renal Disease (ESRD), you’ll need to find the right care. Dialysis centers can vary in the quality of care and services they provide, so it’s important to understand the differences in dialysis centers in your area before you decide where to go for care. If you’re already on dialysis, it’s also important to understand the quality of care that your dialysis center delivers. Medicare’s Dialysis Facility Compare lets you easily search for dialysis centers, compare them side by side, and find the right one for you. The information includes feedback from patients – you can see how dialysis patients respond to a survey that asked questions about their dialysis center, their kidney doctor, and the center’s staff.
March is National Kidney Month, so there’s no better time to get smart about kidney disease. Learn more about kidney disease, Dialysis Facility Compare, and Medicare-covered kidney services to be sure you’re making educated choices about your kidney health.
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Fri, 03/15/2019 – 00:00 […]