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MEDICARE REIMBURSEMENT RATES 2010 Update 08: The House passed legislation

(H.R.4851) to delay until 1 MAY the 21% cut in Medicare payments to

doctors now scheduled for 1 APR and forwarded the bill to the Senate. The intent

was to allow more time for Congress (which went on a two-week recess 26 Mar) to

work out a longer-term fix. But a Senate effort to approve the bill quickly by a

“unanimous consent” procedure hit a snag when Sen. Tom Coburn (R-OK) refused to

consent. Under Senate rules, any senator can object to bringing a bill to the

floor for action. Coburn objected on the grounds that the cost of the bill is

not offset by other spending reductions. Senate leaders could not work out an

agreement on 26 MAR, the last day before their scheduled two week Easter recess.

Thus, the 21% cut will take effect prior to their return on 12 APR. Ironically,

the Senate already passed a six month fix two weeks ago (H.R.4213), but the

House didn’t agree with the funding for the bill and in turn passed only a

one-month fix.

Failure to reach an agreement on an extension on the eve of the

congressional two-week Easter recess could prove detrimental to

Medicare beneficiaries even if Congress applies a retroactive solution when they

return in mid-April. Doctors have become weary of the increasing number of

short-term patches applied by Congress rather than a long-term solution. Some

are already limiting the number of patients who use these programs.

Congress has to find a way to end these monthly crises under which

millions of Medicare beneficiaries are held hostage to the

prospect of devastating payment cuts that will cause their doctors to stop

seeing them. [Source: MOAA Leg Up 26 Mar 2010 ++]

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HEALTH CARE REFORM Update 25:
National health care reform has a key new

benefit for families that will not apply to military families enrolled in the

Tricare health insurance program. A key expansion of benefits in the Patient

Protection and Affordable Care Act, H.. 3590, is a requirement for health

insurers to cover unmarried children up to the age of 26 who are carried on the

policy of a parent. This change, like the rest of the bill, does not apply to

Tricare, according to Defense Department and congressional sources. But

congressional aides, speaking on the condition of anonymity, said several

lawmakers have begun investigating how to alter Tricare so that it also covers

older children who do not have their own coverage. A change is being considered

for inclusion in the 2011 defense authorization bill, which the House and Senate

armed services committees will begin writing later this year. Currently, Tricare

covers unmarried children up to age 23 if they are attending college or up to 21

if they are not. Tricare spokesman Austin Comacho said he could not give a

definitive statement about whether Tricare’s age limit for children would be

changed. “The only thing we can be sure of is that there will be no adverse

impact to our beneficiaries,” he said.

Robert Gates, Secretary of Defense, released a statement on 21 MAR2010

which stated: “Our troops and their families can be re-assured that the health

care reform legislation being passed by the Congress will not negatively impact

the Tricare medical insurance program. In the interim, Rep. Martin Heinrich

(D-NM) introduced a bill on 25 MAR that would extend TRICARE health coverage to

dependent children from age 23 to age 26. The Comptroller estimates this

additional cost would be in excess of $600 million per year. The TRICARE

Dependent Coverage Extension Act (H.R.4923), would require Defense to provide a

key benefit created by the Patient Protection and Affordable Care Act President

Obama signed into law which allows parents to keep dependent children on family

health insurance plans up to age 26. TRICARE is governed by Title 10 of the U.S.

Code and is not affected by the new health care law. H.R.4923 would amend Title

10 to reflect the new requirement, which would take effect 1 OCT 2010. [Source:

NavyTimes Rick Maze & GovExec.com Today articles 22 & 25 Mar 2010 ++]

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HEALTH CARE REFORM Update 26:
Here are the effective dates of major

provisions of the health care overhaul legislation approved 21 MAR:

90 days after enactment:

• Provide immediate access to high-risk pools for people with no insurance for

at least six months because of pre-existing conditions.

• Impose a 10% excise tax on indoor tanning for services provided on or after

1 JUL 2010

Six months after enactment:

• Bar insurers from denying people coverage when they get sick.

• Bar insurers from denying coverage to children with pre-existing conditions.

• Bar insurers from imposing lifetime caps on coverage.

• Require insurers to allow people to stay on their parents’ policies until

they turn 26.

Nine months after enactment – 50% of the donut hole will be covered. Eventually,

the health care reform bill will close the donut hole entirely

Within A Year:

• Provide a $250 rebate this year to Medicare prescription drug beneficiaries

whose initial benefits run out when they enter the donut hole.

• Require new insurance policies to cover certain preventive-care measures

with no out-of-pocket cost to the consumer.

• Require Insurance companies to stop imposing lifetime coverage limits on

your insurance.

• Sharply limit annual caps on your insurance.

• Require Insurers with unusually high administrative costs to offer rebates

to their customers, and every insurance company has to reveal how much it spends

on overhead.

2011:

• Require individual and small group market plans to spend 80% of premium

dollars on medical services. Large group plans would have to spend at least 85%.

• Taxes begin being levied on drug manufacturers.

• Physicians’ Medicare fees will be cut more than 25% unless the sustainable

growth rate is permanently repealed by Congress; –

• Initiate Medicare bonus of 10%over five years for primary care and general

surgery (family medicine, internal medicine, geriatrics and pediatrics)

2012 – Businesses must file Form 1099s for all business-to- business

transactions of $600 or more.

2013 :

• Increase the Medicare payroll tax and expand it to dividend, interest and

other unearned income for singles earning more than $200,000 and joint filers

making more than $250,000.

• Require public reporting of physician performance to begin.

• Begin testing Medicare pilot programs care payments based on “quality over

quantity” of services rendered.

• Make fewer medical expenses tax deductible.

• Raise wage taxes from 1.45% to 2.35%; – New tax of 3.8 percent levied on

unearned income streams like interest and dividends; – New tax of 2.9 percent

on medical device sales.

2014:

• Provide subsidies for families earning up to 400% of poverty level,

currently about $88,000 a year, to purchase health insurance.

• Require most employers to provide coverage or face penalties.

• Require most people to obtain coverage or face penalties for noncompliance.

• Create state insurance exchanges for individuals and small businesses to

purchase coverage.

• Prohibit Insurance companies from denying coverage for pre-existing

conditions.

• Expand Medicaid to all Americans under age 65 earning up to 133% of the

federal poverty level.

• Increase Subsidies for some small business providing coverage to employees.

2015 – Initiate independent Payment Advisory to make recommendations for cutting

Medicare costs.

2016:

• Penalties for individuals refusing to purchase insurance rise to 2.5% of

taxable income or $695, whichever is greater.

• Multi-state compacts allowed to sell policies across state lines

2018 – Impose a 40% excise tax on high-end insurance policies.

2019 – Expand health insurance coverage to 32 million people.

[Source: Speaker of the House, Congressional Budget Office, Kaiser Family

Foundation via McClatchy Newspapers article 21 Mar 2010 ++]

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HEALTH CARE REFORM Update 27: The Obama Administration’s health-care reform,

which passed 219-212 in the House of Representatives 21 MAR and has been signed

into law by the President, will lead to significant changes in the way millions

of people find and buy health insurance. Advocates for consumers and patients

hailed the overhaul’s passage. “While the new reforms won’t solve all the

problems in our nation’s broken health-care system, they will go a long way

toward achieving the goal of affordable, reliable health care for all

Americans,” Jim Guest, chief executive of Consumers Union, said in a statement

after the vote. Immediately following President Barack Obama’s signing of the

bill 12 states filed a lawsuit challenging several provisions of the new law.

The suit alleges, among other things, that unfunded state Medicaid mandates and

forcing individuals to purchase health insurance are unconstitutional. The

lawsuit was filed by the participating states’ attorneys general and names the

U.S. Departments of Health and Human Services, Treasury and Labor. States

joining in the lawsuit include Alabama, South Carolina, Florida, Louisiana,

Nebraska, Texas, Michigan, Utah, Pennsylvania, South Dakota, Washington and

Colorado. In the interim here’s an outline of what you can expect depending on

your employment, income, health and lifestyle factors. The exact timing of

several provisions has yet to be determined:

• If you have employer-sponsored coverage: Any lifetime caps on how much your

health plan will cover, often set between $1 million and $5 million, will be

eliminated in both group and individual health plans starting later this year.

Employers will have to disclose the cost of workers’ health coverage on their

W-2 tax forms starting in 2011.

• If you have a small business: Small firms starting this year may be eligible

for new tax credits that would cover up to 35% of health-insurance premiums for

businesses that have fewer than 25 employees. Workers at small businesses

eventually will be able to buy policies on new health-insurance exchanges, where

health benefits will have to meet a new minimum standard.

• If you’re uninsured: Over the next 10 years, the bill will extend coverage

to an estimated 32 million people who would otherwise lack coverage. It does

this by expanding the government safety net and providing subsidies for low- and

moderate-income people without employer health benefits to buy private plans on

health-insurance exchanges, which are due to start in 2014. For the first time,

all citizens and legal residents will have to buy health insurance — with

financial aid from the government if they can’t afford it, on a sliding scale up

to 400% of the poverty line — or face a penalty starting in 2014, with some

exceptions for low-income people. The amounts are set to rise annually,

beginning with a fine of $95 or 1% of income, whichever is greater, and growing

to as much as $695 or 2.5% of taxable income by 2016.

• If you’re low-income: The law significantly expands Medicaid, the

federal-state health program for the poor, making it available to an estimated

16 million more people with incomes up to 133% of the federal poverty level.

Adults without dependent children will qualify for the first time. In addition,

community health centers, on which many of the working poor rely, will receive

enhanced funding.

• If you’re a young adult: Starting six months after enactment, kids can stay

on their parents’ policies until age 26. Individuals younger than 30 who don’t

have insurance also will have the option of buying catastrophic coverage on the

exchanges, according to the Kaiser Family Foundation.

Tax-related changes

• If you have a flexible-spending account for health expenses: Nothing changes

for three years. A $2,500 cap on contributions to these accounts, which allow

users to sock away money pretax to spend on qualified health expenses, appears

likely to go into effect in 2013. The cap will receive annual cost-of-living

adjustments.

• If you have a health savings account (HSA) or Archer medical savings

account: In 2011, the penalty for withdrawing funds for nonqualified medical

expenses increases to 20% from 10% for HSAs and from 15% for Archer MSAs.

• If your earned or investment income exceeds $200,000: In about two years,

the Medicare payroll tax will rise nearly 1 percentage point to 2.35% on wages

of individuals with earnings greater than $200,000 and married couples earning

more than $250,000. A new 3.8% Medicare tax will be levied on investment income

including interest, dividends and capital gains that exceed those thresholds.

• If you itemize deductions for income tax: Starting in 2013, medical expenses

have to reach 10% of your adjusted gross income to qualify for a tax deduction,

as opposed to today’s 7.5% standard. But seniors age 65 and older would be able

to claim an itemized deduction at 7.5% of income through 2016.

• If you have high-cost health insurance: A so-called Cadillac tax of 40% on

plan administrators offering the richest job-based health benefits will take

effect in the next few years and apply to the amount of annual premiums

exceeding $10,200 for individuals or $27,500 for families. The thresholds are

higher for retirees and workers in certain high-risk jobs.

Medicare, preventive care and tanning

• If you have Medicare: This year, beneficiaries with the Part D drug benefit

who fall into the coverage gap that for 2010 is between $2,700 and $6,154 of

spending will receive a $250 rebate. In 2011, those who hit the gap will receive

a 50% discount on their brand-name drugs. The so-called doughnut hole gradually

will close by 2020.

• If you take advantage of preventive care: Full coverage for some services is

slated to take effect in six months. At that time, all new insurance policies

will have to make certain preventive-care visits and screenings exempt from

health plans’ deductibles and other cost-sharing.

• If you go to a tanning salon: A 10% excise tax on indoor tanning may kick as

early as this summer for services provided on or after 1 JUL 2010.

[Source: Wall Street Journal MarketWatch Kristen Gerencher article 22 Mar 2010

++]

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Rep. Jason Altmire Decides to Vote ‘No’ on Health Care Bill – AOL News.

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The article below I found interesting and wanted to share with anyone who is concerned about happenings in our world today.
We should all be worried about this company and the stuff they are “genetically engineering” that appears to be killing us a little at a time every time we eat something. I’m glad the Obama administration is at least investigating them and the FDA needs to get off of their asses and check into this. It always seems the government, who we rely on to protect us, is always the last ones to act on something. One can only hope the media will get in on this and report it to the public using every media outlet. Yeah, right.
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Monsanto: The evil corporation in your refrigerator
Bob Cesca Feb 4th 2010 at 7:30PM

When we consider the rogue’s gallery of devilish, over-sized, greedy and disproportionately powerful corporations, we generally come up with outfits like Microsoft, Bechtel, AIG, Halliburton, Goldman-Sachs, Exxon-Mobil and the United States Senate. Yet somehow, Monsanto, arguably the most devilish, over-sized, greedy and disproportionately powerful corporation in the world has been able to more or less skulk between the raindrops — only a household name in households where documentaries like Food Inc. are regarded as light Friday evening entertainment. My house, for example. But for the most part, if you were to ask an average American for their list of sinister corporations, Monsanto probably wouldn’t make the cut.

It should.

Founded by Missouri pharmacist John Francis Queeny in 1901, Monsanto is literally everywhere. Just about every non-organic food product available to consumers has some sort of connection with Monsanto.

Anyone who can read a label knows that corn, soy and cotton can be found in just about every American food product. Upwards of 90% of all corn, soybeans and cotton are grown from genetically engineered seeds, also known as genetically modified organisms (GMOs). These genetically enhanced products appear in around 70% of all American processed food products. And Monsanto controls 90% of all genetically engineered seeds. In other words, Monsanto controls — and owns patents on — most of the American food supply.

When you consider, as Walletpop originally reported, that one-in-four food labels is inaccurate, that the F.D.A.’s testing is weak at best, then how can we trust one corporation to have so much control over our produce? The answer is, we can’t.

Recently, a study by the International Journal of Biological Sciences revealed that Monsanto’s Mon 863, Mon 810, and Roundup herbicide-absorbing NK 603 in corn caused kidney and liver damage in laboratory rats. Scientists also discovered damage to the heart, spleen, adrenal glands and even the blood of rats that consumed the mutant corn. A “state of hepatorenal toxicity” the study concluded.

This hasn’t slowed down Monsanto’s profit machine. In 2008, Monsanto cleared over $2 billion in net profits on $11 billion in revenues. And its 2009 is looking equally as excellent.

Author and food safety advocate Robyn O’Brien told me, “Monsanto is expecting gross margins in Q2 2010 of 62%, its corn and soy price mix to be up 8-10% and its glyphosate revenue to expand to an estimated $1 billion in gross profit by 2012, enabling Monsanto to further drive R&D into seeds and to price those seeds at a premium – further driving price increases on the farm and in the grocery stores.”

This, O’Brien says, in the same year when farm income declined by around 34%.

Because Monsanto claims that its GMOs create higher yields and therefore comparatively higher revenues per acre for struggling American farmers, they’re certainly a tempting option. On the surface, that is. Monsanto controls its seeds with an iron fist, so even if you happen to own a farm next to another farm upon which Monsanto seeds are used, and if those seeds migrate onto your land, Monsanto can sue you for royalties.

Additionally, if you use seeds from crops grown from Monsanto seeds, a process known as “seed cleaning,” you also have to pay royalties to Monsanto or it will sue you. All told, Monsanto has recovered $15 million in royalties by suing farmers, with individual settlements ranging from five figures to millions of dollars each.

Back in 2004, farmer Kem Ralph served eight months in jail and was fined $1.3 million for lying about Monsanto cotton seeds he was hiding in his barn as a favor to a friend. They weren’t even his seeds (yeah, that’s what they all say!). By way of comparison, the fine in Ralph’s home state of Tennessee for, say, cocaine possession, is $2,500.

In keeping with the Orwellian nature of modern marketing, one of the first phrases you see on the front page of the Monsanto website is “we help farmers.” Funny. In a cruelly ironical way, that is.

In fairness, the argument in support of Monsanto is generally “it makes more food for lower prices.” Of course this is a red herring. Basic economics proves that choice and competition create lower prices. Not monopolies. This applies not only to American grocery stores, but also in terms of feeding developing nations where food is scarcer. Moreover, stronger Monsanto herbicides, compatible with herbicide resistant seeds, are giving rise to mutant Wolverine-ish super weeds that have adapted and are rapidly spreading through the air to farms that don’t use Monsanto GMOs, destroying obviously vulnerable crops. Say nothing of the inevitable mutant bugs that will adapt to the pesticides that are implanted into the Monsanto Mon 810 genetic code. And if further studies indicate similar organ damage in humans, the externalized costs to health care systems will begin to seriously out-weigh the benefits of cheaper food.

Ultimately, there are better, healthier ways to make cheaper food. Until then the best thing we can do is to demand further investigations and buy organic products whenever practical.

And if you can’t afford to buy organic, O’Brien recommends, “A great first step, given how pervasive these ingredients are in processed foods that often use these ingredients to extend shelf life, is to reduce your exposure to processed foods and stick with pronounceable ingredients and foods that your grandmother would have served her kids.”

Meanwhile, let’s endeavor to make Monsanto a household name. But not in a good way.

On January 15, the Obama Justice Department launched an anti-trust investigation against the corporate behemoth over its next generation of genetically modified “Roundup Ready” soybean seeds. The very next day, the U.S. Supreme Court agreed to hear the case Monsanto v. Geertson Seed Farms, which challenges the safety of genetically modified agricultural products — the centerpiece of the Monsanto empire. If the investigation fails, farmers will have to switch over to the next generation of Roundup Ready seeds in 2014. And the cycle of corporate abuse and monopolization will continue.

Source

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