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Volume 14 Issue 4, April 2017

CMS Issues Proposed Rule to Increase Patients’ Health Insurance Choices for 2018
Medicare Photo

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for 2018, which proposes new reforms that are critical to stabilizing the individual and small group health insurance markets to help protect patients. This proposed rule would make changes to special enrollment periods, the annual open enrollment period, guaranteed availability, network adequacy rules, essential community providers, and actuarial value requirements; and announces upcoming changes to the qualified health plan certification timeline.

“Americans participating in the individual health insurance markets deserve as many health insurance options as possible,” said Dr. Patrick Conway, Acting Administrator of the Centers for Medicare & Medicaid Services. “This proposal will take steps to stabilize the Marketplace, provide more flexibility to states and insurers, and give patients access to more coverage options. They will help protect Americans enrolled in the individual and small group health insurance markets while future reforms are being debated.”.... Read More

Source: cms.gov

April is Alcohol Awareness Month

Alcohol Awareness Month - Take a day off from drinking this week Drinking too much alcohol increases people’s risk of injuries, violence, drowning, liver disease, and some types of cancer. This April during Alcohol Awareness Month, GeorgiaCares encourages you to educate yourself and your loved ones about the dangers of drinking too much.

To spread the word and prevent alcohol abuse, GeorgiaCares is joining other organizations across the country to honor Alcohol Awareness Month.

If you are drinking too much, you can improve your health by cutting back or quitting. Here are some strategies to help you cut back or stop drinking:

  • Limit your drinking to no more than 1 drink a day for women or 2 drinks a day for men.
  • Keep track of how much you drink.
  • Choose a day each week when you will not drink.
  • Don’t drink when you are upset.
  • Limit the amount of alcohol you keep at home.
  • Avoid places where people drink a lot.
  • Make a list of reasons not to drink.

For more information, visit the National Council on Alcoholism and Drug Dependence.

Source: healthfinder.gov 


Medicare Coverage of Alcohol Misuse Screening and Counseling

How often is it covered?
Medicare Part B (Medical Insurance) covers this screening once per year.

Who's eligible?
Adults with Part B (including pregnant women) who use alcohol, but don't meet the medical criteria for alcohol dependency can get the screening. If your primary care doctor determines you're misusing alcohol, you can get 4 brief face-to-face counseling sessions per year (if you're competent and alert during counseling). A qualified primary care doctor or other primary care practitioner must provide the counseling in a primary care setting (like a doctor's office).

Your costs in Original Medicare
You pay nothing if the qualified primary care doctor or other primary care practitioner accepts assignment...Read More

  Source: medicare.gov
AppleFor more information on covered preventive and screening services, call GeorgiaCares at 1-866-552-4464 (option 4) or visit www.medicare.gov.

Chronic Care Management (CCM)

Chronic Care Management

What Is CCM? 

  • If you have Medicare or Medicare and Medicaid, and have two or more chronic conditions, Medicare is offering chronic care management (CCM) services to help you manage your health and spend more time doing the things you love.
  • If you have a chronic condition like Alzheimer’s disease and related dementia, arthritis (osteoarthritis and rheumatoid), asthma, atrial fibrillation, Autism spectrum disorders, cancer, cardiovascular disease, chronic obstructive pulmonary disease, depression, diabetes, hypertension, and infectious diseases such as HIV/AIDS, chronic care management could be an important piece of the care your provider can offer.
What are the benefits of CCM?
  • Regular chronic care management, or connected care, means you can better manage your care and spend more time focusing on your health. CCM can help you work towards your health and quality of life goals.
  • Coordinated care means you’ll get personal attention and help.
    • You can feel secure knowing you’ll gain a comprehensive care plan, and at least 20 minutes a month of chronic care help when you need it, and regular check-ins.
  • Your provider will help you keep track of your health care needs, so your loved ones can spend more quality time with you.
  • You don’t always have to go to the office to get help; you can also make a call.
  • Reaching your provider will help you make the best choices for your health, all from the comfort of your own home.
  • Having a regular touch-base between doctor’s visits will help keep you on track and stay focused on your health.

Read More

For more information on CCM, visit go.cms.gov/ccm.

Source: cms.gov

GeorgiaCares Spotlight

Nichole V. Photo

Nichole Varnell
GeorgiaCares volunteers provide vital services to the Medicare beneficiaries of Georgia. They have the tremendous responsibility of educating individuals on the Medicare program as well as informing beneficiaries on ways to prevent Medicare fraud, errors, and abuse. In acknowledgement of her commitment and dedication, GeorgiaCares would like to recognize Nichole Varnell, a volunteer with the GeorgiaCares Northwest Georgia Area, for a job well done.

Nichole exemplifies the mission of the GeorgiaCares program by providing free, unbiased, and factual information and assistance to beneficiaries in a professional and compassionate manner. Words of appreciation from GeorgiaCares customers were received in which they praise Nichole for spending “week after week, working on and fixing our Medicare and Medicaid.” They thanked Nichole for providing them with “peace of mind” because now they no longer worry about their healthcare.

GeorgiaCares delivers important Medicare assistance to beneficiaries, caregivers, and their families. Our success depends on the efforts of all our volunteers and staff. We are proud to have such a hard-working and devoted individual on our team.

We Are Looking for Volunteers


Learn how you can become a GeorgiaCares volunteer and make a difference in the lives of seniors and persons with disabilities in your area.
Volunteer Button

Chicago Chiropractor Indicted for Allegedly Billing $10 Million to Medicare and Private Insurers for Nonexistent Treatment

Medicare Fraud Photo

A Chicago chiropractor with a clinic in the West Lawn neighborhood has been indicted on federal fraud charges for allegedly submitting at least $10 million in bogus claims to Medicare and private insurers.

Henry Posada submitted the fraudulent claims for purported physical therapy and chiropractic services that were never provided, according to the indictment. In some instances Posada was out of the state on the dates he claimed to have provided chiropractic services, while other times he used his patients’ names without their knowledge to create wholly fictitious claim forms, the indictment states. From 2008 to 2016, Posada submitted at least $10 million in fraudulent claims to Medicare and private insurers, causing those programs to pay at least $5.1 million to Posada and his clinic, Spine Clinics of America S.C., which does business as Associated Back Care and Rehabilitation.... Read More

Source: www.justice.gov

Inside This Issue
News
Medicare Preventive Services
Counseling Tips
GeorgiaCares Spotlight
Fraud in the News
GeorgiaCares Outreach Events
April 8th in Cumming
April 8th in Milledgeville
April 20th in Carrollton

map of Georgia

Contact your local GeorgiaCares office for additional outreach events in your area.
National Minority Health Month 2017

Together we can bridge health equity across communities. Join us for National Minority Health Month 2017!

April Observances
National Minority Health Month
Alcohol Awareness Month
Volunteering Hands
Volunteer Opportunities!
You can make a difference for people with Medicare. Visit our website for more info.
GeorgiaCares
Volunteer of the Month
April 2017

Marlene J. Photo
Marlene J.
Marlene has been a GeorgiaCares Volunteer in Carroll County since 2011.  She conducts outreach at the Open Hands Christian Ministry located in Carrollton. Marlene retired from the Division of Family and Children Services and has a wealth of knowledge which she shares with beneficiaries when providing Medicare assistance. Marlene also participates in a line dance group that performs at senior centers and other locations.
Marlene says she enjoys volunteering for GeorgiaCares because “I like to stay busy. I’m a senior, and I have knowledge in various programs to share.  I enjoy what I do”.

Beware of phone calls that include a recorded message from an "officer with the Inspector General of Social Security" stating that your benefits have been suspended and to call a non-SSA number to resolve the issue. 
This is a potential fraud scheme and individuals should be very careful and avoid responding to suspicious calls.
For more information on this fraud alert, visit blog.socialsecurity.gov.
Stop Fraud Sign
If you suspect fraud, errors, or abuse when you use Medicare or if someone tries to sell you a product or service you don't need, report it by calling GeorgiaCares at 1-866-552-4464 (Option 4)
We would like to hear about your experience with GeorgiaCares. Please email your comments to
Email Envelope
 GeorgiaCares @dhs.ga.gov
Copyright © 2017 Georgia Dept. of Human Services/Division of Aging Services/GeorgiaCares Program
All rights reserved.



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This publication was supported by the Georgia Department of Human Services/Division of Aging Services/GeorgiaCares Program with financial assistance, in whole or in part, through a grant from the Administration for Community Living (ACL) and the Centers for Medicare and Medicaid Services (CMS).