Medicare Monitor
The Palm Beach Post's veteran Washington correspondent, Larry Lipman, tracks policy makers and interest groups who are shaping the future of the federal health insurance program for the elderly.
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Medicare at a glance
Medicare is the federal health care system that covers about 36 million people age 65 and older, plus 7 million disabled. It has four parts:
Part A
Covers inpatient hospital care as well as nursing home, home health and hospice care. Nearly all elderly and disabled Americans qualify for Part A coverage.
Financed by a 2.9 percent payroll tax divided equally between employees and employers.
Part B
Covers outpatient care, doctor’s services, durable medical equipment, home health visits and preventive care. Part B coverage is voluntary, but roughly 40 million are enrolled.
Financed by beneficiary premiums and federal general revenue. Current monthly premiums are $93.50. Starting this year, individuals whose taxable income is more than $80,000 will pay a higher premium.
Part C
Medicare Advantage managed care plans provide health care normally covered by Medicare Parts A and B. They may also provide some other benefits, including prescription drugs, not covered by traditional Medicare. Oart C is voluntary; about 7 million beneficiaries are enrolled.
Financed by Medicare and beneficiary premiums, which vary among plans.
Part D
Medicare prescription drug plans come in two types, those that just cover prescription drugs and those that cover drugs as part of a broader managed care benefit. Part D is voluntary. About 9.2 million beneficiaries are in stand-alone drug plans and about 5.1 million are in managed care drug plans.
The plans are private and financed by Medicare and beneficiary premiums, which vary among plans.
-- Larry Lipman
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Wednesday, April 30, 2008
By Larry Lipman
| Wednesday, April 30, 2008, 11:39 AM
Medicare’s competitive bidding program for durable medical equipment will be questioned at a House Ways and Means health subcommittee hearing next week.
Medicare officials have touted the program as a major way to save money and reduce fraud in sale and rental of equipment, prosthetics, orthotics and supplies. According to Medicare officials, the first round of bids resulted in a roughly one-quarter drop in the price of equipment.
Equipment dealers have argued that the bid process was flawed and that it will put many longtime small dealers out of business because they will be shut out of the program.
“We have heard from both suppliers and beneficiary advocates that the DMEPOS competitive bidding program is not working as well as it is supposed to,” Rep. Pete Stark, D-Calif., the panel’s chairman, said in a statement. “I look forward to hearing their concerns, as well as from CMS, as we consider whether changes need to be made before the program is further expanded.”
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