Articles written by alan m. schlein


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  • Congressional health legislative roundup

    Alan M. Schlein, Senior Wire|Jun 1, 2016

    Normally, in a presidential election year, Congress doesn’t get much done. This year is no exception. But with a few months before July’s political nominating conventions, a brief window of productivity exists and some lawmakers are pushing bipartisan proposals to help change Congress’ gridlock image. Let’s look at what’s on the agenda (with the exception of the seemingly never-ending attitudes and activities surrounding Obamacare) over the next couple of months before politics overwhelms all congressional activity. Congress left town for...

  • Analysis: Drug pricing options proposed, presupposed, opposed

    Alan M. Schlein, Senior Wire|May 1, 2016

    Most Americans and leading presidential candidates on both sides of the aisle support the idea that the federal government should lower drug prices. But it's not likely to happen any time soon even though the Obama administration and Congress are considering some proposals and ideas moving in that direction. This is a key issue for the 55 million seniors on Medicare. A recent Stanford Center on Longevity study found that almost half (47 percent) of Americans age 75 and older took five or more prescription drugs in 2011, nearly double the 24...

  • Struggling to afford the next big health care crisis: Chronic and long-term care

    Alan M. Schlein, Senior Wire|Apr 1, 2016

    Editor's note: This is an expanded version of the story appearing in the April 2016 Senior Voice print edition. The next big health crisis is the battle over chronic care and long-term care. Patient advocates, policy experts and lawmakers call it the “silent crisis” – one that potentially will affect every American family: the inability to plan and pay for long-term care. Some modest bipartisan cooperation to find a solution is emerging, despite it being a contentious election year. A bipartisan group of senators are trying to find actua...

  • What is an ACO and what does it mean to me?

    Alan M. Schlein, Senior Wire|Mar 1, 2016

    Editor’s note: The ACOs discussed in this national story have not reached Alaska, but the emphasis on outcomes for patients and reimbursing for coordinated care will become increasingly relevant to the health care system as a whole. Big changes are coming for most seniors as the Obama administration aggressively pushes to change the way doctors are paid – moving from tying their fees for every service provided to payments based on the quality of the care patients receive. This means a big expansion in an effort by Medicare to keep seniors hea...

  • Where the presidential candidates stand on Medicare, Social Security

    Alan M. Schlein, Senior Wire|Feb 1, 2016

    As the 2016 presidential primaries and the nomination fights move to the political front burner, a look at the health care and Medicare policies of the candidates raises questions of how far the candidates and their parties want to go in pushing for changes. Republican presidential candidates are sharply divided over whether to seek drastic changes to Medicare, Social Security and other entitlement funds at the same time as Congressional Republicans continue to push repealing Obamacare. Democratic presidential candidate Hillary Clinton is...

  • Latest Medicare changes affect senior dollars

    Alan M. Schlein, Senior Wire|Jan 1, 2016

    A new law signed by President Obama will help shield some 17 million Americans from steep premium hikes. But many will continue to see changes in the amounts they pay for Medicare next year. About 30 percent of Medicare beneficiaries were facing a 52 percent increase in their Medicare Part B medical insurance premiums and deductible in 2016. But Congress and the Obama Administration worked out an agreement so beneficiaries will pay about $119 per month instead of $159.30 for Part B. The remaining 70 percent of Medicare beneficiaries will contin...

  • Medicare open enrollment is also open season for scams

    Alan M. Schlein, Senior Wire|Nov 1, 2015

    Medicare’s open enrollment, the time you can keep or switch your Medicare coverage, runs from October 15 until December 7. To Medicare scammers, open enrollment means open season on seniors. The best advice to prevent yourself from being taken advantage of by these con artists and scammers is jarring but to the point: be rude and just hang up the phone. If a solicitation comes via email or on a website, don’t click on the link, as it may open you up to a computer virus. You may also need to watch out for predatory insurance agents, who som...

  • Congress changes billing rules for hospital 'observation care'

    Alan M. Schlein, Senior Wire|Oct 1, 2015

    Here is some Medicare bad news, disguised as good news. Congress has finally moved to change the laws about observation care, a problem that’s been vexing seniors for years because the laws are unclear. This has forced millions of seniors to face huge unexpected medical bills when they get home from short hospital stays. Congress has supposedly “fixed” the problem – with the House and Senate approving legislation, but the fix appears to be a step in the right direction, without fixing the actual problem. Under legislation that passed the Sen...

  • Medicare to provide coverage for end-of-life counseling

    Alan M. Schlein, Senior Wire|Sep 1, 2015

    Doctors are different than you and I. They know how to die. They do not tell family and colleagues to do “everything you can” to save them. This may surprise you, but doctors often choose less end-of-life care for themselves than the average patient – an important lesson for seniors as they discuss end-of-life care decisions with family members. In July, the Centers for Medicare and Medicaid Services (CMS), which administers Medicare, announced it will change its longstanding policy and begin reimbursing doctors and other health professionals,...

  • One in six seniors have inadequate access to food

    Alan M. Schlein, Senior Wire|Aug 1, 2015

    Millions of seniors are struggling to put food on the table, a dramatic spike in the problem, according to two new reports. Despite the recent uptick in the U.S. economy, an astonishingly large number of Americans – 9.6 million over the age of 60 – could not reliably buy or access food at least part of the year. That’s one in every six older men and women. And those numbers are much lower than the reality. Analysts say that large groups of seniors aren’t even being included in those numbers because it’s hard to reach them to find out they aren...

  • Data sheds light on escalating medical costs

    Alan M. Schlein, Senior Wire|Jul 1, 2015

    The prices that hospitals ask customers to pay for a series of common procedures have increased by more than 10 percent between 2011 and 2013 – more than double the rate of inflation, according to new data released recently by Medicare. But the amounts paid by Medicare have stayed flat, according to that data. The hospitals’ rising list prices mainly affect the uninsured and people who use hospitals outside their insurance network. The 2013 Medicare billing information was part of a large release of data breaking down spending based on hos...

  • Analysis: Republican budget bill proposes marked changes in Medicare coverage

    Alan M. Schlein, Senior Wire|Jun 1, 2015

    Check off “budget” on the Republicans “can govern” checklist. Congressional Republicans recently approved a budget bill, the first passed by Congress in six years, and the first since the party took control of both chambers earlier this year. The non-binding document, however, does not go to President Obama for his signature. Instead, it helps guide Congress in framing how it wants to consider all of the government agency appropriations bills. It will also serve as a Republican fiscal policy guideline and sets the stage for the 2016 preside...

  • Supreme Court poised to rule on Obamacare: What it could mean for coverage and costs

    Alan M. Schlein, Senior Wire|Mar 1, 2015

    For the second time in three years, the U.S. Supreme Court could determine the fate of the president’s health care law with a case coming up for oral arguments in March. While a limited number of seniors are covered under the health care law, a Court decision could have a big impact financially on your health care costs if the High Court rules the law unconstitutional. With President Obama controlling the veto pen over Congress, lawmakers and the White House will continue their health care legislative standoff. Two years ago, the Supreme Court...

  • Medicare rules, boondoggles and fraud fights

    Alan M. Schlein, Senior Wire|Jan 1, 2015

    Medicare is like a government octopus, with its tentacles stretching into almost every aspect of senior life. With its policies affecting 50 million beneficiaries, this agency has a lot going on simultaneously. Sometimes, policies it puts in place get lost in the shuffle, as it has with its obesity program (see below). Other times, people figure out how to game the system, resulting in huge fraud and abuse. So as often happens at year end, the agency, formally known as the Centers for Medicare and Medicaid Services (CMS), has been issuing...

  • Huge backlog result of broken Social Security bureaucracy

    Alan M. Schlein, Senior Wire|Dec 1, 2014

    Last spring the nation was outraged when the enormous backlog of claims at the Veterans Administration was revealed. The number of claims stuck in processing for more than 125 days at that time was 611,000 veterans who were not getting their claims processed. Seven months later, that number, the VA says now, has dropped to 344,000 claims that are still 125 days behind. While there was bipartisan anger over the VA scandal, a recent Washington Post story reveals a dramatically worse backlog over...

  • Medicare changes could limit ALS patients' coverage

    Alan M. Schlein, Senior Wire|Dec 1, 2014

    Last summer’s viral “ice bucket challenge” focused attention and helped raise money for ALS – amyotrophic lateral sclerosis – a disease that impairs motor function so people often can’t talk or even move. But while public attention focused people on the disease, Medicare changes already in the works could now seriously curtail coverage of communication tools that ALS patients need. Unless it is delayed, beginning Dec. 1, people with ALS could lose access to technological advances that allow them to better communicate, as a result of what Med...

  • High drug costs prompt calls for government price controls

    Alan M. Schlein, Senior Wire|Sep 1, 2014

    Sovaldi, a new drug, which has been hailed as a breakthrough treatment for the 3.2 million Americans infected with hepatitis C, costs $1,000 a pill. While it is highly effective and has fewer side effects and takes less time than older therapies, it costs $84,000 for a typical patient. But lawmakers want to know why the U.S. price is much higher than in other countries, as well as previously estimated in the U.S. In a letter sent recently, two U.S. senators, Finance Chairman Ron Wyden, D-Ore., and Sen. Charles Grassley, R-Ia., asked Gilead...

  • Debating Medicare coverage for smokers

    Alan M. Schlein, Senior Wire|Aug 1, 2014

    Bipartisanship has surfaced, at least briefly, on Capitol Hill. More than 130 lawmakers, from both parties, are urging the Obama Administration to expand coverage for a lung-cancer test under Medicare – screening they see as vital for vulnerable seniors. But the decision could cost Medicare billions of dollars. In a letter to the Centers for Medicare and Medicaid Services, the lawmakers called for a timely decision on coverage for low-dose CT scans for older patients at higher risk of d...

  • New Medicare benefits you should know about - but probably don't

    Alan M. Schlein, Senior Wire|Jun 1, 2014

    Dying patients may find it more difficult to get certain medications under new rules Medicare has recently put in place. Meanwhile, another set of rules could make it easier for seniors to get Medicare to pay for home health care services. Medicare has recently issued different sets of rules for payments involving hospice care and home health care services, as a result of a lawsuit settlement. But both of the rules changes are complicated and confusing and seniors may need some help in working their way through the changes. In an effort to crac...

  • Administration retreats on Part D changes

    Alan M. Schlein, Senior Wire|May 1, 2014

    The White House, after an aggressive pushback from seniors, patients, pharmaceutical companies and lawmakers from both parties, recently scrapped most of a proposed plan to limit Medicare coverage for certain classes of drugs including those used to treat depression and schizophrenia. In January, the Centers for Medicare and Medicaid Services proposed broad changes to the Medicare Part D prescription-drug program that covers medicines for about 39 million beneficiaries. Medicare officials had said the proposal would save money and reduce the...

  • Analysis: Proposed Medicare Part D changes incite cheers, jeers

    Alan M. Schlein, Senior Wire|Apr 1, 2014

    When do you fix a government program that’s not broken? That’s the question many in Washington are asking, after Medicare recently proposed a series of changes to its Part D prescription drug program – a program that, by most everyone’s view, is working very well. The Centers for Medicare and Medicaid Services (CMS) proposed new rules recently that would fundamentally change the program's private insurance coverage for certain drugs, alter the pharmacy networks that some plans cover and limit the number of policies available to benefic...

  • New health care model adapts to changing realities

    Alan M. Schlein, Senior Wire|Aug 1, 2013

    Ever forget to take your pills or simply fail to measure your blood sugar or some other routine health care daily chores? Would it help you remember if you knew that a nurse was coming by regularly to check in and make sure you were doing what you were supposed to do? Simple things sometimes can be revolutionary. A Medicare experimental program, being tested in Doylestown, Pa., that brings a nurse to regularly visit you for continued care – even when you aren’t seriously ill – has been given an 18 month reprieve from being shut down. If it is...

  • Love it or leave it health care

    Alan M. Schlein, Senior Wire|Jul 1, 2013

    While the Obama administration battles with the Republican House of Representatives this summer in the public relations fight over getting people to sign up for the new health care insurance coverage, key decisions affecting millions of poor folks are being made at the state level with major consequences. Supporters and opponents are squaring off in efforts to sell or roll back the implementation of the Affordable Care Act, known as “Obamacare.” Both sides want to get the tactical advantage in advance of when people start to sign up for health...

  • The Medicare 'observation' muddle

    Alan M. Schlein, Senior Wire|Jun 1, 2013

    After five days in the hospital with a fractured spine, Jean Arnau was discharged and needed to transfer to a skilled nursing facility for rehabilitation. Only then did her family find out that she had never been formally admitted as an inpatient to the hospital. While the care the 84-year-old Rhode Island woman got was exactly the same, she had been classified as an outpatient under “observation” – a status that cost her thousands of dollars more than she would have paid if she had been admitted as an inpatient. The same thing happened to Lo...

  • Analysis: Budget battles' increasing impact on seniors

    Alan M. Schlein, Senior Wire|May 1, 2013

    President Barack Obama took a political gamble at the beginning of April by proposing to curb the growth of Medicare and Social Security. In upsetting his liberal political base, Obama hopes his concessions will draw rank and file Senate Republicans into a budget deal that, so far, has proven elusive. Obama released his proposed $3.778 trillion budget recently, for the fiscal year beginning in October – the first salvo in a long process full of political gamesmanship, partisan rhetoric and hopefully, ultimately, an agreement on a broad d...

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