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Personal Health Record Tool to Aid Beneficiaries in South Carolina

On Wednesday, May 7, the Centers for Medicare and Medicaid Services announced a pilot project to allow Medicare beneficiaries access to personalized medical information. This should, if the project is successful, allow them to play a more active role in their health care choices.

The project involves a Personal Health Record tool, which is an on-line record of health information, controlled by the beneficiary. In this pilot, it contains data entered by the individual and by Medicare. When the beneficiary registers and request it, hospital and provider medical claims can be automatically entered into the Personal Health Record.

This offers the beneficiary a number of advantages. It allows them to look up information pertaining to their health conditions, supplies on-line links to relevant health topics, and gives them control over who sees the information in the Personal Health Record tool. It presents beneficiaries with the ability to see a more complete medical history, increases their access to research material (allowing them to better understand their own medical conditions and needs), and ultimately provides them with more support.

The project began on April 4 of this year, and should continue for 12 months. The Centers for Medicare and Medicaid Services will use the information gathered from this pilot project to help them make decisions regarding future Personal Health Records.

Medicare Announces New Protections Proposal for People Enrolled in Medicare Advantage and Prescription Drug Programs

On May 8, 2008, The Centers for Medicare & Medicaid Services proposed measures to further protect those in MA health plans and Medicare prescription drug plans.  The proposal is in addition to other protective steps taken by CMS recently, such as posting summaries of corrective action against MA plans online and creating a rating system for plan performance.  The new changes are intended to continue to ensure Medicare beneficiaries, or potential beneficiaries, in MA plans and drug plans are treated fairly and transparently.

The proposal would require a number of specific measures.  For instance, it would prohibit cold-calling and door-to-door solicitation.  It would limit an appointment with a beneficiary to market health care products to what the beneficiary has already agreed to.  It would prohibit sales at educational events or waiting rooms.  It would limit the value of promotional items offered to potential clients, as well as the type.  It would introduce measures to help enrollees get the information to select the best plan for their health care needs. 

There are also measures in the new proposal to streamline extra-help eligibility determinations, to reduce beneficiary liability, and to create specific cost sharing protections.  Additionally, the proposal would allow Medicare clearer authority in calculating financial penalties against MAs or prescription drug plans that break Medicare rules, negatively affecting beneficiaries. 

The measures suggested by the new proposal should see increased protection of Medicare Advantage and Medicare Prescription Drug Plan beneficiaries and, hopefully, increased confidence in the integrity of the system. 

The Flu Shot: An Important Preventive Service

The Flu Shot is covered each flu season for all beneficiaries in a Medicare program.  It is given once a year, either in the fall or in the winter, and is an important factor in staying healthy. 

The flu, or influenza, is a contagious infection which is commonly spread though coughing, sneezing, or direct contact.    It can cause a number of symptoms, ranging from congestion and a sore throat, to muscle pain and fatigue, to fever and chills, to, albeit  rarely, nausea and diarrhea. Some people will have only a few symptoms, others will have many.

Although the flu shot won’t necessarily prevent you from getting the flu, your symptoms will likely be milder if you’ve had your vaccine. It’s a good idea to get your shot between September and November, since December is when the flu begins to gain prominence.  However, because flu season is considered to be from November to April, you should get your flu shot even if you missed the fall vaccination.  

In addition to getting a flu shot, you can take other steps to help prevent the spread of influenza.  Wash your hands often, with soap and water.  Try not to frequently touch your mouth or nose. If possible, try not to be in close contact with others who have the flu.  If you are sick yourself, stay home from work and keep your distance from people, when possible. Also, make sure you cover your mouth when coughing or sneezing. 

Medicare covers a number of essential preventive services, including the Flu Shot. Make the most out of your coverage: remember to get your flu shot each year.