Medicare Compliance & Reimbursement

Expect to see some unhappy Medicare beneficiaries.

The good news for providers is that 2005 will herald new physician pay increases, preventive and health screening benefits, and improvements to the Medicare Advantage program. But the bad news is for beneficiaries: they're about to be hit with the biggest increase in Medicare premiums yet. 

The Department of Health and Human Services said Sept. 3 that beneficiaries can expect premiums to rise by 17 percent next year - and three-fourths of that hike is attributable to additional Part B costs rung up under the Medicare Modernization Act. Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment and other items.

What your patients can expect in 2005:     Monthly premiums: For Medicare Part B, the increase is set at $78.20, up $11.60 from $66.60 in 2004. 
      Deductible: For Medicare Part A, the deductible for 60 days of inpatient hospital coverage would be $912, up $36 from $876. Part B will be raised to $110. 
      Coinsurance: For beneficiaries in skilled nursing facilities, the daily co-insurance for days 21 through 100 will be $114, compared to the current $109.50. Those who enroll in Medicare Advantage plans may not be affected by the Part A increase, an HHS release said.

Rep. Pete Stark (D-CA), ranking member on the Health Subcommittee of the Committee on Ways and Means, said that the premium and deducible increases coupled together were a "double whammy for America's 40 million Medicare beneficiaries." Centers for Medicare & Medicaid Services Administrator Mark McClellan said the hike was part of creating an "enhanced Medicare."