Things That Medicare and Social Security Won't Tell You

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Things Medicare Won't Tell You.  The government's massive entitlement program is full of costly glitches.
By Catey Hill | SmartMoney – Wed, Dec 21, 2011

1. "We fork over millions for unproven procedures."
Medicare spends millions of dollars each year on treatments that many medical experts deem unnecessary. One example: Digital mammograms. These are often more expensive than traditional mammograms but not necessarily better for older women. A five-year clinical trial conducted by the National Cancer Institute found that digital mammograms were no more effective in finding cancers in women 50 and older than traditional mammograms. But the number of digital mammograms that Medicare paid for has risen from 426,000 in 2003 to nearly 6 million in 2008 -- a jump that increased the cost of breast cancer screening by more than $350 million, according to an analysis by The Center for Public Integrity, a nonprofit investigative news organization.

Medicare also often pays significantly more for liquid-based cytology, a screen for cervical cancer, than it does for routine pap smears, even though a large 2009 study found that the expensive test is no more effective than the traditional procedure when it comes to detecting cancer. Using the newer, more expnsive test costs Medicare an extra $90 million since 2003, according to The Center for Public Integrity. Another point of contention is that Medicare pays for screening colonoscopies for people over 75 despite the fact that the United States Preventative Task Force "recommends against routine screening for colorectal cancer in adults age 76 to 85 years."

Medical experts argue that testing shouldn't always come down to cost. "One person's 'unnecessary' care is another person's necessary," says Joe Baker, president of the Medicare Rights Center. "Medicare pays for most tests or procedures that a doctor orders." Still, there are many unnecessary procedures that Medicare pays for each year that are outside or clinical guidelines, some of which could be eliminated with better doctor and consumers education, he adds. A spokesman for the Center for Medicare and Medicaid Services (CMS) says that it "pays for services that are reasonable and necessary" though it does try to "provide physicians as much flexibility as possible in using their judgment to design a treatment plan that meets the patient's needs."

Rest of story at: http://www.smartmoney.com/retirement/planning/10-things-medicare-wont-tell-you-1324333528533/?link=SM_hp_ls1e

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Things Social Security Won't Tell You -"The secret of bigger benefits, and the truth about the agency's bottom line."
By JONNELLE MARTE

1. "Long-term deficit? We can hardly afford our bills today."

Worried about the future of Social Security? You're far from alone. The Social Security Administration itself has said that unless something is done to reform the system, it will burn through its funds within the next few decades. Less talked about, perhaps, is the concern about the present: the program is having a hard time paying its bills. In 2010, the Social Security Administration collected less revenue in taxes than it needed to cover its benefit payments -- the first time expenditures have exceeded income since 1983. As a result, the program had to tap its $2.5 trillion trust fund, sooner than some had expected. The same is expected to happen this year. "The depth of the recession has slowed down revenues to the system," say Eugene Steuerle, an economist with the Urban Institute, a non-partisan think tank in Washington, D.C.

A Social Security spokeswoman points out that interest income from the Treasury bonds held in the trust fund will allow it to keep growing until 2022 -- even if the agency has to siphon off some money to offset any shortages in tax revenue -- and won't be exhausted until 2036, when the first Gen Xers begin retiring. But that's already one year earlier than previous projections. After that, the agency says tax income under the current system will only cover about 75% of benefit payments through 2085.

Rest of story at: http://www.smartmoney.com/retirement/planning/10-things-social-security-wont-tell-you-1314999788631/?link=SM_clm_sum

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Watch for Billing Snafus
By ANNA WILDE MATHEWS

On Jan. 1, insurers, doctors' offices and hospitals are supposed to start using a new format for certain digital communications, including claims filed for payment.

The switchover doesn't involve consumers directly, but they should watch out for hiccups that could delay payments or generate unexpected bills in the early part of next year.

A spokesman for the Centers for Medicare and Medicaid Services, the federal regulator overseeing the shift, says that "consumers should not experience disruptions in receipt of their health-care services," and the agency is getting "very positive" feedback from the health industry about readiness for the upgrade to the new format, generally known as version 5010.

America's Health Insurance Plans, an association of health insurers, says its "members have indicated that they will be ready by the Jan. 1 deadline." Officials of the American Hospital Association say "most of our members are ready."

Still, there are signs that there could be at least some problems.

Rest of story at:  http://online.wsj.com/article/SB10001424052970204879004577110380150318246.html?link=SM_pln_hc_res