Posts Tagged ‘CMS’

“Patients Over Paperwork:” Medicare is reviewing regulations to reduce provider burden

The Centers for Medicare & Medicaid Services (CMS) is reviewing regulations that mandate how doctors and other practitioners document the services they provide. The focus is on the following:

  • Reducing unnecessary burden
  • Increasing process efficiencies
  • Improving the patient’s experience with their provider

CMS is beginning this process with evaluation and management services (office or outpatient visits). The goal is to increase the time providers spend with their patients and decrease the time spent documenting services. At the same time, CMS consistently seeks to reduce provider errors and unnecessary appeals.

CMS Administrator Seema Verma explained: “…we are moving the agency to focus on patients first. To do this, one of our top priorities is to ease the regulatory burden that is destroying the doctor-patient relationship. We want doctors to be able to deliver the best quality care to their patients.”

To see more information about the Patients Over Paperwork initiative, please visit the CMS website at https://www.cms.gov/About-CMS/story-page/patients-over-paperwork.html.

If you have questions about your Railroad Medicare coverage, you may call Palmetto GBA’s Beneficiary Contact Center at 800-833-4455, or for the hearing-impaired, call TTY/TDD at 877-566-3572. Customer service representatives are available Monday through Friday, from 8:30 a.m. until 7 p.m. ET. Visit Palmetto’s Facebook page at https://www.facebook.com/myrrmedicare/.

Visit Palmetto GBA’s free online beneficiary portal at www.PalmettoGBA.com/MyRRMed. This tool offers you the ability to access Railroad Medicare Part B claims data, historical Part B Medicare Summary Notices (MSN), and a listing of individuals you have authorized to have access to your personal health information.

Medicare Part B premium costs for 2016

Palmetto_rgb_webThe Centers for Medicare & Medicaid Services (CMS) has released the 2016 Part B premium and deductible costs for 2016. Railroad Medicare processes claims for Part B services. 

The 2016 monthly premiums will remain unchanged for approximately 70 percent of Medicare beneficiaries. However, the remaining 30 percent will pay a different amount based on the following criteria:

  • those enrolling for the first time in 2016
  • individuals not receiving Railroad Retirement/Social Security benefits
  • those who are directly billed for their Part B premiums
  • those who have Medicare and Medicaid and Medicaid pays the premiums, or
  • individuals whose modified gross incomes from two years ago is above a certain threshold

For beneficiaries who meet one of those criteria, Part B premiums for 2016 will be based on their annual income in 2014.

Those filing individual tax returns with annual incomes (in 2014) noted here will pay the following in 2016:

  • less than or equal to $85,000 will pay $121.80 in 2016
  • greater than $85,000 and less than or equal to $107,000 will pay $170.50
  • greater than $107,000 and less than or equal to $160,000 will pay $243.60
  • greater than $160,000 and less than or equal to $214,000 will pay $316.70
  • greater than $214,000 will pay $389.80

Those filing joint tax returns with annual incomes (in 2014) noted here will pay the following in 2016:

  • less than or equal to $170,000 will pay $121.80  
  • greater $170,000 and less than or equal to $214,000 will pay $170.50
  • greater than $214,000 and less than or equal to $320,000 will pay $243.60
  • greater than $320,000 and less than or equal to $428,000 will pay $316.70
  • greater than $428,000 will pay $389.80

The rates are slightly different for married beneficiaries who lived with their spouse (at any time during the year) and file separate tax returns. Those filing separate tax returns with annual incomes (in 2014) noted here will pay the following in 2016:

  • Less than or equal to $85,000 will pay $121.80
  • Greater than $85,000 and less than or equal to $129,000 will pay $316.70
  • Greater than $129,000 will pay $389.80.

The Medicare Part B deductible will be increasing from $147 per year in 2015 to $166 per year in 2016. 

If you have questions about your Part B Premium, you can call the Railroad Retirement Board toll free at 877-772-5772 or for the hearing impaired (TTY) call 312-751-4701. General information can also be found at the RRB’s website at www.rrb.gov.

If you have questions about your Railroad Medicare coverage, you can call the Beneficiary Contact Center at 800-833-4455, or for the hearing impaired, call TTY/TDD at 877-566-3572. Customer Service Representatives are available Monday through Friday, from 8:30 a.m. until 7 p.m. ET.

Report dependent SSNs to retain health coverage

This is a final effort to collect dependent Social Security numbers to comply with new federal law for all medical plans including:

  • The Railroad Employees National Health and Welfare Plan; and
  • The National Railway Carriers and United Transportation Health and Welfare Plan

Federal Law now requires the reporting of Social Security numbers (SSNs) for covered dependents to the Centers for Medicare & Medicaid Services (CMS).

This includes participants of all medical plans, including the railroad plans listed above.

In addition, if a covered dependent is eligible for Medicare, then the Medicare Health Insurance Claim Number (HICN) is also required.

To comply with these reporting requirements, Railroad Enrollment Services has mailed a final notice to those members identified with missing dependent SSNs and/or HICNs.

If you have received a notice from Railroad Enrollment Services, please provide the SSN and/or HICN for any dependent who is listed as missing this information.

Be sure to sign, date and return the Social Security Number Reporting Form by the requested return date to the address provided.

If you do not receive a notice requesting missing dependent SSNs and/or HICNs, then you do not need to take any action at this time.

The following will occur if the requested SSNs are not provided for any dependent added to the plan before Jan. 1, 2009:

If Railroad Enrollment Services does not receive the Social Security number for any dependent whose SSN is missing by Jan. 31, 2011, the dependent(s) will be DISENROLLED from the plan effective Jan. 31, 2011.

Be assured that when Railroad Enrollment Services transmits the SSNs and/or HICNs to CMS, they will maintain all physical, electronic and procedural safeguards that comply with federal standards to guard your personal information.

For additional information regarding the new CMS federal law pertaining to this requirement, visit www.cms.hhs.gov/MandatoryInsRep/.

If you have questions, or need another copy of the notification sent to you, call Railroad Enrollment Services at 800-753-2692.

Additionally, there will be an opportunity to provide missing dependent SSNs and/or HICNs during the 2011 Annual Open Enrollment process in the month of October. 

UTU rail-member health insurance alert

Federal law now requires the reporting of Social Security numbers (SSNs) for covered dependents to the Centers for Medicare & Medicaid Services (CMS).

Employees who have not yet provided dependent SSNs will have their dependents’ coverage terminated on July 31.

This includes participants of all medical plans, including the Railroad Employees National Health and Welfare Plan and the National Railway Carriers and United Transportation Union Health and Welfare Plans.

In addition, if a covered dependent is eligible for Medicare, then the Medicare Health Insurance Claim Number (HICN) is also required.

To comply with these reporting requirements, Railroad Enrollment Services has mailed a final notice to those members identified with missing dependent SSNs and/or HICNs.

If you have received a notice from Railroad Enrollment Services, provide the SSN and/or HICN for any dependent who is listed as missing this information — and sign, date and return the Social Security Reporting Form by the requested return date to the address provided.

If you do NOT receive a notice requesting missing dependent SSNs and/or HICNs, you need not take any action at this time.

The following will occur if the requested SSNs are not provided:
  • For any dependent who was newly added to the plan between Jan. 1, 2009 and May 31, 2010: If Railroad Enrollment Services does not receive the Social Security number for any newly added 2009/2010 dependent whose SSN is missing by July 31, 2010, the dependent(s) will be disenrolled from the plan effective July 31, 2010.
  • For any dependent who was added to the plan before Jan. 1, 2009: If Railroad Enrollment Services does not receive the Social Security number for any dependent whose SSN is missing by Jan. 31, 2011, the dependent(s) will be disenrolled from the plan effective Jan. 31, 2011.

When Railroad Enrollment Services transmits the SSNs and/or HICNs to CMS, they will maintain all physical, electronic and procedural safeguards that comply with federal standards to guard your personal information.

For additional information regarding the new CMS federal law pertaining to this requirement, visit:

www.cms.hhs.gov/MandatoryInsRep/.

If you have questions or need another copy of the notification sent you, call Railroad Enrollment Services at (800) 753-2692.