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Railroad Medicare
Affordable Care Act Reaches Second Birthday

On March 23, 2010, President Obama signed into law the Affordable Care Act (ACA), with many Americans seeing some immediate benefits. Outlined here are some of these important changes this important new law has brought to Medicare:

Prescription Drug Savings
More than 5.1 million seniors and those with disabilities have saved more than $3.2 billion dollars in prescription drug costs, a direct result of the $250 rebate check sent to seniors who hit the 'donut hole' in 2010, and in 2011, a 50% discount on brand-name drugs when they reached the 'donut hole'.

Preventive Services
Free preventive services in 2011 were received by more than 25,700,000 Americans, including the new Annual Wellness Visit. These services, prior to 2011, had been subject to the Part B deductible and coinsurance/copayment, and include such services as bone mass measurements, Hepatitis B vaccine, tobacco cessation counseling, and medical nutrition therapy for certain individuals.

America’s War on Fraud
One important benefit from the ACA has been increased scrutiny regarding Health Care Fraud. Now, individuals found guilty of Medicare fraud face large penalties and fines, in addition to increased jail time. Agencies such as the Health Care Fraud and Enforcement Action Team (HEAT) coordinate, share intelligence, and train with the Department of Justice and Department of Health and Human Services (HHS). The Centers for Medicare and Medicaid, a division of HHS, reported one single action by the HEAT Medicare Strike Force in 2011 resulting in 115 individuals in nine cities arrested for their alleged participation of more than $240 million of false billings to Medicare. Another Strike Force action saw 91 individuals in eight cities arrested for their alleged part in defrauding more than $290 million from Medicare. While this is all welcome news, it is the $4.1 billion in recoveries made in just 2011 that brought the greatest savings to the Medicare Trust Fund.

Looking Beyond
We can expect increased partnering between hospitals, health care providers, patient advocates, and state and federal agencies to better coordinate patient care. The ACA also created Medicare payment incentives to those hospitals, health care providers and health care plans delivering a higher quality of care.

For questions about general Railroad Medicare coverage, please call our Beneficiary Contact Center at (800) 833-4455 or for TTY, call (800) 377-4950. Representatives are available Monday through Friday from 8:30 a.m. to 7 p.m. ET. We also invite you to visit our Facebook page called 'My RR Medicare' at
www.facebook.com/myrrmedicare.

 

last updated on 04/02/2012
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