#medicare 8 minute rule

[healthiermetoday7]

Medicare's 8-Minute Rule: A Complete Guide for Healthcare Professional

Discover how the Medicare 8-Minute Rule can optimize reimbursement and streamline healthcare operations. Learn the ins and outs of this crucial Medicare guideline on Healthier Me Today's comprehensive guide.

[unifymedicraft]

Medicare 8 Minute Rule

The Medicare 8 Minute Rule is a guideline used by physical therapists to discover how much time can be billed. Accurate calculation of total treatment time is required by therapists so they may tailor the case to the 100 allowable treatment units available from Medicare. It’s a rule that charges units on time spent, so you’ll be billed for 8 minutes minimum. Knowing this rule is important for therapists to optimize patient care while meeting Medicare billing guidelines exactly.

[mvprehab]

Medicare Physiotherapy

Medicare covers physical therapy in many settings including hospitals, homes, and rehabilitation centers. If you have a Medicare Advantage plan (Medicare Advantage), which typically bundles Part A and Part B, it may also cover your physical therapy.

To qualify for a Medicare-covered visit, a licensed physician or therapist must create and regularly review a plan of care. Learn how to create defensible documentation at every patient visit. To know more about Medicare Physiotherapy, visit the MVP Rehab Physiotherapy website or call 0450603234.

Original Medicare, or Part A and Part B, covers physical therapy sessions if your doctor or therapist determines it is medically necessary. Medicare Part B, or medical insurance, typically covers 80% of the cost after you meet the deductible. These services can be provided at your doctor’s office, an outpatient rehabilitation or “rehab” facility, a hospital outpatient department or at home through a Medicare-certified home health agency.

Inpatient physiotherapy is also covered under Medicare Part A, but you will have to pay the inpatient deductible and copayments that apply. Medicare Advantage plans, or Part C, may also include these coverages but your costs will vary.

Medigap, or Medicare supplement insurance, may help cover your deductible and other out-of-pocket expenses. Check with your Medigap plan to see if they offer coverage for Medicare physiotherapy. Some plans may even pay for Medicare Part B’s deductible, which would save you money in out-of-pocket expenses. If you decide to purchase a Medigap plan, choose one with the best price/value for your situation.

Medicare Part B helps pay for outpatient physical therapy, as well as occupational therapy and speech-language pathology. However, a physician must deem these services medically necessary. Part B also covers durable medical equipment that can help patients with daily living activities, such as bathing and dressing. Part B pays 80% of the Medicare-approved amount after the patient meets the deductible. The patient is responsible for the other 20%, unless they have a Medigap plan that pays Part B coinsurance.

If a clinic accepts Medicare, it must comply with the guidelines set by the Center for Medicare Advocacy, which includes documenting therapy visits using dictation and creating defensible written documentation at every visit. While some private practice physical therapists choose to “opt-out” of Medicare, this can result in a loss of revenue and a possible audit by the CMS. Some Medicare Advantage plans require a beneficiary to use practices within an established network and may have different deductibles and coinsurance.

As long as a physical therapist deems it medically necessary, Medicare Part B will cover most of the cost. This includes the deductible and coinsurance.

Medicare Advantage, or Part C, plans also typically cover PT sessions. However, the exact coverage varies by plan.

For example, some plans require a doctor’s referral before starting therapy. Others may limit the number of sessions per year. Some plans also charge a monthly fee.

Another thing to keep in mind is that if the direct treatment is performed by a physical therapy assistant (PTA), then only 80% of the service will be covered. In addition, there is a “8-minute rule” for PTA billing. This means that a total of 8 minutes of direct treatment must be provided for a session to be billable by Medicare.

Many Medicare beneficiaries take out Medigap insurance to help pay for additional costs related to PT, such as copayments and deductibles. The AARP has an excellent guide for understanding these types of policies.

Medicare now doesn’t cap therapy sessions as long as doctors can prove they’re medically necessary. Original Medicare Part A and Part B both cover physiotherapy sessions in hospitals, therapists’ offices, or at home after an inpatient hospital stay. Medicare Advantage plans, also known as Medicare Part C, offer the same benefits at a lower cost.

However, some Medicare Advantage plans implement appointment caps and other restrictions to control costs. To help offset these added expenses, beneficiaries might consider a Medigap policy. To know more about Medicare Physiotherapy, visit the MVP Rehab Physiotherapy website or call 0450603234.

Medigap is private insurance that helps pay Medicare’s deductibles, coinsurance, and copayments. Beneficiaries should compare the 10 standardized Medigap plans to find which one is best for them.

[tachyon-at-rest]

Environmental protection

Dismantling the Clean Air Act: A rule made final Wednesday exempts a large number of stationary sources of air pollution (that is, sources other than vehicles) from clean air regulations. The rule designates as “significant” polluters only those in categories deemed to contribute more than 3% of total U.S. greenhouse gas emissions. But the sheer magnitude of the onslaught creates a problem in itself. Most of the new rules are subject to repeal under the Congressional Review Act, which allows for the reversal by both houses of Congress of regulations implemented in the waning months of a departing administration. But that will require a lot of votes.

Dismantling the Clean Air Act: A rule made final Wednesday exempts a large number of stationary sources of air pollution (that is, sources other than vehicles) from clean air regulations. The rule designates as “significant” polluters only those in categories deemed to contribute more than 3% of total U.S. greenhouse gas emissions. Experts say that this arbitrary threshold would chiefly cover only power plants, leaving oil and gas producers exempt from clean air oversight. Indeed, the Environmental Protection Agency acknowledges that the rule is designed to immunize the “development of domestic energy resources” from environmental oversight. “This is a lights-are-shutting-off, last-ditch, heading-out-the-door attempt to trip up climate action by the incoming administration,” says Julie McNamara of the Union of Concerned Scientists. McNamara calls the 3% threshold an “invented metric” with no basis in science. The rule, she says, “violates so many rule-making requirements; but it does delay action by wasting time and resources, and that comes at a cost.” The provision may be especially vulnerable to legal challenge because it was bootstrapped to a different regulatory proposal. The EPA never solicited public comment on the 3% standard, a baseline administrative requirement of any regulatory change of this magnitude.

False scientific “transparency”: On Jan. 3 the EPA made final a rule ostensibly designed to improve the “transparency” of the science underlying regulatory initiatives. BUSINESS Column: In the name of scientific ‘transparency,’ Pruitt’s EPA hobbles its own ability to regulate polluters. As we’ve reported before, however, this rule is a wolf in sheep’s clothing — it actually would hobble the work of regulators. That’s why it has long been on the wish list of right-wing climate change deniers in Congress and the executive branch.

Softening fuel efficiency penalties: For the third time, the Trump administration is issuing a rule to undermine the penalties levied on automakers that fall short of government fleet fuel efficiency standards

Medicaid and healthcare

Work rules and block grants: Medicaid, the pubic health program for indigent households, is second to none among government programs in the hostility it has attracted from the Trump administration. Virtually since Trump’s inauguration, he has taken steps aimed at throwing tens of thousands of Americans off the Medicaid rolls. In the last few months, those efforts have intensified. The administration in October approved work requirements for Medicaid enrollees in two states, Georgia and Nebraska, despite a long record of such requirements being rejected by federal courts. Ample evidence exists, moreover, that work requirements don’t achieve either of the goals their proponents hold dear: They don’t reduce joblessness and they don’t improve people’s health. On the contrary, they reduce enrollment, in part because they typically come with administrative requirements that low-income households can’t meet and that state bureaucracies can’t manage. Why the Trump administration would continue drinking from this poisoned well in the face of legal and social disaster is a mystery. But its love for work rules remains robust; Seema Verma, administrator of the government’s Centers for Medicare and Medicaid Services and a prime promoter of this deplorable policy, seldom avoids a chance to be on hand for announcements of her agency’s approval of the rules. Curiously, the Supreme Court decided last month to consider Medicaid work rules. The decision has healthcare advocates “scratching their heads,” says Sara Rosenbaum, a public health expert at George Washington University, because lower courts have been unanimous in overturning those rules. Moreover, the court set a deadline for the federal government’s brief in the case of Jan. 19 — the day before the Trump administration becomes the Biden administration — which is certain to stifle the work-requirement craze for good. On Jan. 8, Verma’s agency also approved a Medicaid block grant for Tennessee. As we’ve reported, block grants merely set state Medicaid programs up for budget cuts. The Trump administration crows that block grants would provide states more “flexibility” in designing their Medicaid programs, but the truth is exactly the opposite.

Hamstringing Biden health reform: In another initiative, Verma’s agency has been trying to get states with Medicaid demonstration projects — including work rules — to sign documents limiting the federal government’s right to end those projects if they’re shown not to work. Under those documents’ terms, Rosenbaum says, the administration would not be able to unilaterally terminate the demonstrations. “They’d have to go through a lengthy procedural process to do so,” she says. “That’s wholly unjustified under the department’s own rules. They gave nobody any chance to comment. This is a piece of policy-making, and they should have given the public a chance to see it and comment on it.”

Anti-discrimination

LGBTQ protections: The Department of Health and Human Services bulled ahead Wednesday with a final rule weakening anti-discrimination protection for LGBTQ people in federal health and social services programs. The rule allows agencies to give religious concerns greater weight in deciding whether or how to serve those enrollees. As congressional Democrats noted, expanding religious exemptions “will eviscerate uniform nondiscrimination protections that apply to all HHS programs.... with potentially dangerous consequences for the Americans we represent.” This administration initiative has been kicking around for more than a year. Anti-discrimination advocates have been warning about its potential effect all along. There’s no logical reason for Health and Human Services to make it final now, in the week before the Trump administration ends, since it’s more than likely that the Biden administration will be expanding LGBTQ protections, not shrinking them. But now there’s just one more obstacle they’ll have to climb over to do so.That just brings the Trump scorched-earth program up to the last week of the Trump presidential era. As we write, there are several more days to go. To paraphrase Bette Davis’ Margo Channing in the movie “All About Eve”: “Fasten your seat belts. It’s going to be a bumpy ride.”

[medical681]

Medical Fundamentals Explained

The Best Guide To Medical

Table of ContentsA Biased View of MedicalThe Facts About Medical RevealedMedical Can Be Fun For EveryoneUnknown Facts About MedicalSome Ideas on Medical You Need To Know

The Single Strategy To Use For Medical

It's tough to believe, yet we're already at the mid-point of the year. And also 2021 is toning up to be another remarkable year for the health care sector. With and also points starting to open, we assumed it would certainly be an interesting time to analyze the arising patterns that have actually specified the initial half of the year.

There is some good information individual quantity appears to have recoiled. When we look at (i. e - medical., cancerous lumps), claims quantity for the last four months of 2020 was at or regarding 100% of the 2019 volume for the exact same duration. As well as in March 2021, claims volume was 103% of the March 2019 volumes, showing even more individuals are returning to seek screenings for delayed care.

It's not unexpected that an unique worldwide pandemic affected the psychological health of so several people. medical. As we come off the heels of it's comforting to see individuals looking for treatment, specifically considering just how lengthy culture stigmatized people with psychological health and wellness conditions. Pattern 5: The shift in treatment places One more interesting shift we are seeing is where patients are looking for out care.

Medical Can Be Fun For Everyone

Healthcare was already trying to relocate specific types of care outside the healthcare facility's four wall surfaces when the pandemic hit. We've seen a sluggish however constant decrease in' share of total diagnosis as well as treatment insurance claims since 2016. On the flip side, we've seen the share of total cases for boost during that exact same timeframe.

Information provided by Conclusive Medical care's; accessed Might 2021. Clinical insurance claims information also suggested an increase in the number of treatments as well as diagnoses at, as well as a boost in medical diagnosis claims at. Fad 6: The surge of telehealth Associated with the shift in care locations, COVID-19 stimulated the.

With insight on which specialties have one of the most demand, to alleviate fatigue as well as minimize companies' work. Fad 9: A rise in elective surgeries After a pause on, the quantity seems returning as COVID-19 rates drop and also inoculation prices increase. According to information from our medical case database,.

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Suppliers will certainly require to work above ability to meet stifled need while stabilizing the brand-new clients that likewise need these elective procedures. Trend 10: The influence of COVID-19 on obesity Feeling like you place on the "quarantine 15" during the COVID-19 lockdowns? When looking at data from Q1 2021, there were an average of 2. medical.

The Senate may use the budget settlement procedure to press through a COVID-19 relief bundle and some healthcare-related policies. Budget plan settlement requires only a majority vote, as contrasted to a supermajority vote for regular legislation. Budget plan reconciliation can only take place a couple of times per year, generally talking, when the budget is up for approval, as well as is restricted to budget-related items.

Medical Fundamentals Explained

While a few of the ACA expansions, boosted subsidies, and also tax obligation debts might happen via budget reconciliation, this process would not be available for larger picture wellness policy problems that are unassociated to the government budget. These larger picture items include issues such as a public alternative, Medicare for all, as well as decreasing the Medicare qualification age to 60.

To load in frontline spaces, numerous organization team participants who typically concentrate on procedure improvements in care setups are doing frontline job., an effort for neighborhoods and wellness frontline employees to advertise infection prevention and infection control.

See This Report about Medical

A Light at the End of the Tunnel but Even More Difficulties to Come: The COVID-19 Injection In 2021, on the various other side of COVID-19's tolls, is a light at the end of the passage: the COVID-19 injection.

The 8-Minute Rule for Medical

Figure 3: COVID-19 vaccination hesitancy in the United States. As of December 2020, individuals in their 50s and also older, city residents, those with a home participant with a health and wellness problem, Democrats, as well as Hispanic grownups appeared more likely to get the vaccination, and women were extra most likely than guys.

[thepoliticalpatient]

RBG’s death all but guarantees the loss of the ACA

Last night was almost as hard and scary as election night, for me.

I will try to keep this brief as I can and so will be focusing on the impact of RBG’s death on healthcare policy in the US. Her death is a tragedy in many other ways, of course. She was a groundbreaking and iconic figure in the judiciary. She was forced to continue working through numerous illnesses and on her deathbed because she was in the position of serving as a 5′1″ human barrier between our already terrible reality and a much more terrible one. and And of course, her death will have numerous awful political consequences in subjects outside of healthcare. I will not be touching on any of that here. I’m sorry, I know it’s incredibly gross to move straight into the politics so fast, but there are millions of lives on the line and we have no time to lose!

The case against the ACA, now called California v. Texas, will start oral arguments on November 10, one week after the election. I have already written a number of posts on the background of this case - this one explains the basis for the case, and this one describes how the lower court has already ruled.

Obviously none of us can tell the future, but before RBG’s death, most folks were pretty optimistic about this case working out in favor of the ACA 5-4. All 5 justices who ruled in favor of the ACA in one of its previous challenges, NFIB v. Sebelius, were still on the court. Obviously this has now changed.

So the case will be heard starting on November 10. From there we should probably expect it to take months to come to a decision. Let’s talk about scenarios:

Trump and Senate Republicans manage to force through a nominee before the election

We all remember 2016 when McConnell refused to hold hearings for the nomination of Merrick Garland to SCOTUS because it was an election year. That seat was stolen by Neil Gorsuch after Trump’s election.

Surprising nobody, McConnell is a hypocrite. RBG’s body was still warm yesterday when he started politicking, releasing a statement indicating that he intends to fill the seat before the election.

If he succeeds, then of course the ACA’s chances are very slim of surviving a challenge in a 6-3 majority conservative SCOTUS.

We delay the confirmation until after inauguration

There is a nonzero possibility that this confirmation can be delayed until the new president is elected and inaugurated.

Republicans have a 53-47 majority in the Senate right now; they need 50 votes to approve a SCOTUS justice (Pence breaks ties).  Prior to RBG’s death, several sitting Senate Republicans stated that they would oppose voting on a nominee during the 2020 election year in order to be consistent with what they did in 2016. Take for instance this absolutely chef kiss video of Lindsey Graham:

https://twitter.com/vanitaguptaCR/status/1307153104941518848

I want you to use my words against me. If there’s a Republican president in 2016 and a vacancy occurs in the last year of the first term, you can say Lindsey Graham said let’s let the next president, whoever it might be, make that nomination.

Other Republican Senators who have made similar statements:

Lisa Murkowski: https://www.alaskapublic.org/2020/09/18/alaska-senator-murkowski-said-friday-she-would-not-vote-for-a-justice-ahead-of-election/

Chuck Grassley: https://thehill.com/business-a-lobbying/410686-grassley-says-judiciary-panel-wouldnt-consider-supreme-court-nominee-in

Susan Collins?: https://twitter.com/jmartNYT/status/1307112333253148672

Mitt Romney? Mixed signals. There’s this, https://twitter.com/JimDabakis/status/1307120855454044160, but his staff denies it: https://twitter.com/LJ0hnson/status/1307129082971385858

Sorry my sources aren’t better on some of these; this is all I’ve got right now. We will have to listen to what these 5 say over the next few days. We only need 4 of them to vote no. If any of them conveniently “change their minds” they will probably cite McConnell’s logic that this year is somehow different because Obama was a lame duck in 2016. Susan Collins and Lindsey Graham in particular might be pressurable because they’re both facing very tough challenges for their seats this year. We should keep the pressure on by pledging donations to their opponents, Sara Gideon and Jaime Harrison, in the event that they make the hypocritical decision to approve a nominee less than 2 months before an election.

I know we can’t trust these people as far as we can throw them but we have to try. What other choice do we have?

Another factor here is the special election in AZ. Martha McSally was appointed to John McCain’s seat after his death, after she previously lost her election against Kyrsten Sinema. She is being challenged this year by astronaut Mark Kelly, who is polling very well. If he wins, because of special election rules, he could be sworn in as early as November 30, reducing the Republican majority in the Senate well ahead of inauguration day.

McSally has already stated that she will vote for a nominee before the election: https://twitter.com/SenMcSallyAZ/status/1307123253845032960

Unfortunately, merely delaying the confirmation of a new justice won’t be enough to save the ACA

The situation is every bit as bad for the ACA against an 8 justice court as it would be against a court with a new conservative justice. In the case of a 4-4 tied decision, the lower court’s decision holds. And the Fifth Circuit’s ruling was that the fate of the ACA should be left to district judge Reed O’Connor, a far-right activist judge who already ruled that the entire ACA should be thrown into the garbage.

The only hope it has is if we both delay the confirmation of a new judge, elect Joe Biden, elect a Senate that will not be hostile to his nominee, and get that nominee through, all before the case is decided. The case will begin with oral arguments on November 10.

A legislative salvation for the ACA?

If we get control of both branches of Congress and the presidency, there is a very easy way to save the ACA. The entire case is null and void if we reinstate the individual mandate’s tax at any amount over $0. A $1 tax would save it. A Democratically-controlled Congress could pass such legislation with a simple majority.

But maybe we should just let it die?

Some members of the left seem to think it’s not such a big deal if the ACA goes under. Their argument is that without the ACA, the case for Medicare for All will become more urgent. They don’t care about the chronically ill and disabled people who will die without protections in the meantime. And besides that, what chance does M4A have of surviving a 6-3 conservative SCOTUS? The fucking ACA, as insufficient and centrist as it is, has been challenged mercilessly in the courts by conservatives. This is the third major SCOTUS case they’ve brought against it. M4A would fare no better. In fact, we can expect to say goodbye to any possibility of keeping any progressive policy within our lifetimes under a 6-3 conservative SCOTUS.

So what do we do?

For now, we put the pressure on Murkowski, Grassley, Graham, Collins, and Romney. If you live in AK, IA, SC, ME, or UT, call their offices every damn day until they commit to voting no on any judge nominated before Inauguration day.

Phone numbers:

Murkowski: (202) 224-6665

Grassley: (202) 224-3744

Graham: (202) 224-5972

Collins: (202) 224-2523

Romney: (202) 224-5251

For folks who do not live in those states, pressure your Republican Senators even if it it seems hopeless, and make a lot of noise about donating to the above 5′s opponents if they vote yes. Volunteer to phone or text bank to ask constituents in those 5 states to call those Senators. There’s still plenty you can do.

Then we must do everything we can to elect Joe Biden and a Democratic Senate. Vote on November 3. Phone or text bank for Biden. Adopt a Senate race in a swing state here: https://votesaveamerica.com/adopt-a-state/

If they push a nominee through, it’s time to pack the courts

If they’re going to change the rules on us and confirm a SCOTUS justice in an election year, then we will change the rules on them the minute we get power.

Adding more justices to SCOTUS does not require a Constitutional amendment. It can be done through legislation, and it has been done many times before:

1789-1807: six seats

1807-1837: seven seats

1837-1866: ten seats

1866-1867: nine seats

1867-1869: eight seats

1869-present: nine seats

Even the threat of opening the door to court packing might be enough to convince some Senators not to move forward with this scheme.

But again, in order to pack the court, we need to elect Joe Biden, flip the Senate, and keep the House.

Let’s get to work.

[colethewolf]

And people like you are the reason we will never have Medicare for All, or the Green New Deal. Stop being a useful tool to the ruling class and helping elect their preferred candidate.

The only people who will EVER manage to get any kind of laws passed to get free healthcare and climate change under control are democrats. That’s how it works. The US is a two party system, democrats and republicans. One party, the republicans, will never give you medicare for all and flat out don’t even believe in climate change. The second party, the democrats, as imperfect as the party is, will work towards providing healthcare to people and actually believe in SCIENCE. 

The problem with people like you is that you want things to change right now, right this minute, ELECT BERNIE RIGHT NOW, IT’S THE ONLY WAY. And that’s why the republicans are winning right now. Because things do NOT and will NOT change with a simple election. It will take years and years to get this country into the shape that the people deserve it to be in. And guess what, the only way that that will ever happen is if we have democrats in power, in the house, the senate, and as president.

But not just for one term. If Trump gets kicked out in the next election and a democrat gets into power, guess what. That president will spend their entire term (possibly 2) fixing up all of the messes that Trump’s administration has created, whilst battling against republicans, getting barely anything done as far as change goes. Which means after those 4-8 years, we will need to elect ANOTHER democrat and keep democrats in power to move forward into establishing new foundation. 

And we’ll literally never get there because why? Because of people like you. Because what will happen is that Warren or Biden will get the nomination and instead of voting for Warren or Biden, people like you will actually throw tantrums because Bernie didn’t get nominated, call the whole thing rigged, and then: refuse to vote during the presidental election, vote third party, or write in somebody who’s not on the ballot, all while running around on twitter talking up how democrats are just as evil and dangerous as republicans.

Then Trump will get re-elected and literally, you WILL be partially to blame. The lives put into suffering or the grave because of climate change and absurb healthcare regulations will be partially your fault and it’s because you’re too obsessed with looking cool and edgy “eat the rich!!! feel the burn!!!”

[marvelsmostwanted]

We’re 10 minutes in and Amy Klobuchar just interrupted to say “on page 8 of the bill it says” and Jake Tapper has already had to ask people to please stick to the rules of the debate, meanwhile Bernie is literally sipping tea while everyone else argues about Medicare for All

Oh and I forgot Marianne Williamson is somehow still here

[littleharpethcrossfit]

Saturday, Feb. 15      Tabata Planks & Hollow Rocks.....Deadlifts.....20 Minute AMRAP.....100 Med-Ball  Partner Sit-ups.

Probably the coldest morning of the year when the SELECT CREW did this at 0730.  It should warm up to merely freezing by 0930 when you arrive.

Warmup #1:  Big Robert led our mobility/flexibility session.  He started it off with a jog in the park.

Warmup #2:     Tabata:    Alternate  Planks & Hollow Rocks     4 Rounds each

Strength WOD:            Deadlifts          8/8/8/8/8

Ed/Shane=295     Robert/Larry=275     Coach/Hunter/Zac/Warren G=225     Dyer=215     Warren A=165     Dana/Angela=145     Linda=110     Joe/Smoothie/Elisa/Sandy/Siv=95     Alice=75     Timmy/ Andy=??

The WOD:               20 Minute AMRAP           The Shane Rule Applies

10 Push Press      ( 95 E / 75 / 55 )

10 Sumo Deadlift High Pulls      ( 95 E / 75 / 55 )

10 Box Jumps     ( 24/20 )

Elites:

Larry/Ed=12      Shane=11 2/3     Andy/Robert=9*

RXers:

Dyer/Zac=12 2/3     Miss Linda=12     Hunter/Warren G/Dana=11     Angela=8    

Scalers:

Elisa=10 1/3     Warren A=10     Coach=9 2/3     Sandy=9      Joe=8     Alice/Siv=7

Physical Therapy Re-Hab Class:

Timmy/Smoothie=13

     Cool-Down:     100 Partnered Med-Ball Sit-ups

Notes:

Robert insisted that he would have gotten a few more rounds if I had not slowed his partner down by showing him pictures.  That’s why Roberts’ score has that little * beside it for special recognition.  Little people stumble over little things.  He’s also angry because the new Trump tax law is costing him almost $500 more for 2019.  That’s probably a 0.000005% increase in his tax bill.  Just wait until he see’s the bill for Medicare for All, Free Tuition, Reparations, Student Loan Forgiveness, $22 an hour Minimum Wage, and the $12,000 a year Guaranteed Salary. 

In case you are wondering how one gets to be in the SELECT CREW, I’ll tell you:  Firstly, you have to be the Affiliate Owner or his family.  Secondly, the SELECT CREW membership is by invitation only, and invites generally go to DEPLORABLES.  Thirdly, special hardships will be entertained, but don’t make a habit of importuning.  

Sunday at 1 PM.  The weather should be PERFECT.   

[healthiermetoday7]

Understanding Medicare and the 8-Minute Rule

The 8-Minute Rule from Medicare is put in place to keep order and understanding when billing patients. It ensures the correct amount is being charged and helps the patient understand how the Medicare time is billed. For time-based codes, there is the 8-Minute Medicare Rule. Before getting paid by Medicare, there must be a direct treatment for at least eight minutes.

[healthiermetodaysblog]

Shailene Woodley Engaging with Psychological sickness

Darling film star shailene woodley illness is to be serious in her twenties. She leaves acting work during this period and perplexing by her dysfunctional behavior. She feels so separated and alone during this period. She had battled to rest at one point because of her brain being "ceaselessly wrecked". Going through treatment and changing her way of life she became better, persuaded, and come over her ailment. To know more data about this, visit our blog now.

[jenroses]

Friendly reminder to people in the US that if you are on a brand name prescription drug with no generic, the drug company is probably happy to pay your copays. 

How do you do it?

1. Google the name of your drug and copay assistance. So today, I googled “Lantus copay assistance” because I had already hit my out of pocket max and didn’t care.

2. Scroll past the ads to the one that is “yourdrugname.com”, so in this case, the first result with “lantus.com” as the domain name.

3. Click through to the site. Read the fine print. If you have medicaid, medicare or certain other government funded insurance, you won’t qualify (you shouldn’t need it with medicaid.) If you have any sort of private/employer type insurance, you should. If you have no insurance at all, this may or may not be the best discount option, or they may have an assistance program that asks about your income. NOTE: MOST OF THESE KINDS OF COPAY ASSISTANCE THINGS DO NOT HAVE INCOME LIMITS. I’m on three vastly different brand name drugs, all of them have copay assistance that asks nothing about income to qualify. Fill out the stuff. Now, I did it on my phone.... and downloaded the card PDF to my phone... and showed my phone to the pharmacist about 5 minutes later and I’m not sure whether the drug costs $40 per month or $70 per month but this is going to erase that, which is great since I fill 3 months at a time. 

It’s usually that easy, depending on the company. 

Now, on the one hand, I’m glad these programs exist because it basically means that being on Xeljanz, Lantus and Xarelto means that my actual out of pocket expenses this year are going to be basically every time I go to the doctor and every lab test I get until, oh, probably April, when the copays on Xeljanz alone would be enough to wipe out my out of pocket costs, and Pfizer will “pay” every penny of that.

On the other hand, I hate the fact that they use these to make there be no consequences or consumer pressure about drug prices... because these programs allow them to inflate the price with no actual cost to the consumer, while milking insurance companies, who turn around and charge people $1600 to insure two adults and a kid. 

How does that work?

Let’s look at a drug like, oh, Simponi Aria, which has a program which will pay up to $20,000 of your infusion costs on a fancy credit card that they reimburse doctors with, leaving people like me with only the office cost at the infusion center and a $5 copay. One infusion might cost $10,000, your insurance plan might charge you a $2500 deductible and then pay 80% or 70% of the remainder, leaving you on the hook according to them for about $4000 total... only in steps Pfizer and covers all but $5 of that. Nice of them...  you’ve chipped 4000 off of your $8000 out of pocket max on the first infusion!  8 weeks later you get a second infusion, $10,000, Insurance pays 80%... and Pfizer pays $2000 of that (by pays I mean writes off, but it counts to the insurance company) and boom, you’re up to $6000 of your OOP max. 8 weeks later, you’re less than halfway through the year and you max out your OOP completely.... Pfizer paid out $2000 of the $10000 total....  And the next time? Because you get these every 8 weeks until you develop a sensitivity....  The next time Pfizer doesn’t write off a dime because the insurance company pays the whole thing. So Pfizer priced their drug so that the end cost is $10,000 per dose (I am actually low-balling this, my actual bill was over $10,000 before insurance touched it, insurance contract brought that down to $9600 or something, $10,000 is just easier math than the actual $10,461.)  And at about 7 infusions per year, Pfizer wrote off $8000 and made $62,000 for 7 doses of medication (minus doctor markup but whatever, if they’re only making $40,000 on this drug it’s still obscene compared to the $8000 they wrote off under the guise of being generous.) Anyway. So we need single payer healthcare for all and to not have to deal with this absolute bullshit, but in the meantime, these things not only diminish your immediate outlay for expensive drugs, but apply directly to your astronomical deductible and OOP max. 

Once you hit the max, you stop having copays for anything that is approved by your insurance company, and they are not yet allowed to put a max on what you need, like they used to. So once I hit my out of pocket max, I usually get any non-emergent labs and studies done, get new cpap supplies, and stop trying to avoid the emergency room on financial grounds, aka, why I didn’t check myself in when I was having a nervous breakdown in February because one hospital stay (which drug companies won’t help with) would result in a bill that we would have to pay out of pocket and the added financial stress was not conducive to furthering my mental health, whereas toughing it out and waiting until the inevitable $2000 per month that Xeljanz tosses at my OOP max builds up and I no longer have to worry about it, at which point my stress level will be lower anyway and I won’t need it.

The math on Xeljanz is a little different... my insurance company pays half, it doesn’t go to deductible. It costs a bit over $4000 per month, so that’s $2000 per month to the OOP max. It is March 2. In the past 9 weeks I have filled two Xeljanz 1-month supplies, 3 months worth of Lantus and 3 months worth of Xarelto. Janssen pharmaceuticals (Xarelto) paid all but $30 of the $180 my insurance company didn’t pay of the $1200 it cost. $10 per month is cheaper for me than generic coumadin (by a huge margin when you factor in PT testing!). Lantus will probably be $180 as well, but the company that makes that will pay all of that, my insurance company will pay $40, and so by the end of March, drugs alone will have put me at roughly $6700 out of my $7900 OOP max. When I factor in $80 per specialist vist x probably 6 specialist visits, $40 per PT visit at 6 PT visits, and IDK 5 times seeing primary care @ $40 and 1 time urgent care for $70.... that’s about another $1000...  So i’m guessing my OOP max will be met in early April, and that at that time I will have spent actually about $1200 on various doctor and therapy visits, and maybe $30 on labwork will go towards my deductible. If I can stay out of the hospital, which, because of the deductible not being met, would be a Financial Bummer. Because we’re already paying $1600 per month for insurance in the first place. Cheaper than the alternative tho. Because Xeljanz rings in at about $50,000 per year without insurance, and their assistance only covers something like $15,000 max.

It’s a drug that came out of taxpayer funded research in the US 25 years ago. Pfizer refused to develop it further until Congress changed the rules so that drugs developed with taxpayer funds no longer had a price limit.

TL:DR You can get help with your prescriptions, we need single payer universal, and the assholes that came up with “value pricing” are going to be the first up against the wall when the revolution comes. This is why the drug lobby needs to be stopped.

Fun times.

[donman2112]

This is very interesting - Sort of puts things in perspective... PoliMath -THIS is too true to be funny. The next time you hear a politician use the Word 'billion' in a casual manner, think about whether you want the 'politicians' spending YOUR tax money . A billion...  Is a difficult number to comprehend, but one advertising agency did a good job of putting that figure into some perspective. A   A billion seconds ago it was 1959. B   A billion minutes ago...  Jesus was alive. C   A billion hours ago... Our ancestors were living in the Stone Age. D   A billion days ago... No-one walked on the earth on two feet. E.   A billion dollars ago...  Was only 8 hours and 20 minutes, at the rate our government is spending it. While this thought is still fresh in our brain... let's take a look at New Orleans  ... It's amazing what you can learn with some simple division. Louisiana Senator, Mary Landrieu (D) was asking Congress for 250 BILLION DOLLARS To rebuild New Orleans. Interesting number... What does it mean? A   Well .. If you are one of the 484,674 residents of New Orleans (every man, woman and child) You each get $516,528 B   Or, if you have one of the 188,251 homes in New Orleans... Your home gets   $1,329,787. C   Or...  If you are a family of four...  Your family gets $2,066,012. Washington, D.C... "HELLO! Are all your calculators broken"??? Taxes WE NOW Pay... Building Permit Tax CDL License Tax Cigarette Tax Corporate Income Tax Dog License Tax Federal Income Tax (Fed) Federal Unemployment Tax (FUTA) Fishing License Tax Food License Tax Fuel Permit Tax Gasoline Tax Hunting License Tax Inheritance Tax Inventory Tax IRS Interest Charges (tax on top of tax) IRS Penalties (tax on top of tax) Liquor Tax Luxury Tax Marriage License Tax Medicare Tax Property Tax Real Estate Tax Service charge Taxes Social Security Tax Road Usage Tax (Truckers) Sales Taxes Recreational Vehicle Tax School Tax State Income Tax State Unemployment Tax (SUTA) Telephone Federal Excise Tax Telephone Federal Universal Service Fee Tax Telephone Federal, State and Local Surcharge Tax Telephone Minimum Usage Surcharge Tax Telephone Recurring and Non-recurring Charges Tax Telephone State and Local Tax Telephone Usage Charge Tax Utility Tax Vehicle License Registration Tax Vehicle Sales Tax Watercraft Registration Tax Well Permit Tax Workers Compensation Tax (And to think, we left British Rule to avoid so many taxes!) STILL THINK THIS IS FUNNY?  Not one of these taxes existed 100 years ago, and our nation was the most prosperous in the world. We had absolutely no national debt. We had the largest middle class in the world. And Mom stayed home to raise the kids. What happened??? Politicians! And we now have to Press '1' For English. The United States currently has an Annual Budget Of $4.407 Trillion Dollars "The U.S. federal budget deficit for fiscal year 2019 is $985 billion. FY 2019 covers October 1, 2018, through September 30, 2019. The deficit occurs because the U.S. government spending of $4.407 trillion is higher than its revenue of $3.422 trillion. The deficit is 18 percent greater than last year. The FY 2018 budget created a $833 billion deficit. Spending of $4.173 was more than the estimated $3.340 revenue." https://www.thebalance.com/current-u-s-federal-budget-deficit-3305783 Whats A Trillion Dollars? A trillion dollars = $1,000,000,000,000. That's 12 zeroes to the left of the decimal point. A trillion is a million million dollars. If you laid one dollar bills end to end, you could make a chain that stretches from earth to the moon and back again 200 times before you ran out of dollar bills! One trillion dollars would stretch nearly from the earth to the sun. It would take a military jet flying at the speed of sound, reeling out a roll of dollar bills behind it, 14 years before it reeled out one trillion dollar bills. Foolish politicians make pronouncements about the strength of the economy. The total unfunded obligation and debt of the United States now exceed 238 TRILLION DOLLARS, and Congress denies the President $5 Billion dollars to protect the American borders. COGITATE! “if you started the day Jesus Christ was born and you spent a million dollars every day since then you still would not have spent a trillion dollars.” I hope this goes around the U S A at least 100 times! What the heck has happened to our Country?

[scottfeldberg]

Medicare’s 8-minute rule is a stipulation that applies to time-based CPT codes for outpatient services, such as physical therapy. Introduced in December 1999, the 8-minute rule became effective on April 1, 2000. The rule allows practitioners to bill Medicare for one unit of service if its length is at least eight (but fewer than 22) minutes. A billable ‘unit’ of service refers to the time interval for the service. Under the 8-minute rule, units of service consist of 15 minutes each.

[zeemedicalbilling]

8-minute rule

The 8 minute rule states that you must provide treatment for at least eight minutes to receive Medicare reimbursement.