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Minority and lower-income populations are less likely to have orthopedic surgery – and more likely to experience poor outcomes when they buy levitra in canada do.Untreated musculoskeletal conditions can result in sedentary behavior that leads to or worsens co-morbidities, including diabetes, obesity, depression and opioid misuse.Access challenges are partly to blame. Disadvantaged populations face many barriers to care, including low referral rates, lack of Medicaid acceptance and transportation difficulties.Telehealth experts say that offering remote education and physical therapy to patients can improve access for vulnerable populations, including:● Patients in rural communities who live far away from brick-and-mortar care facilities.● Patients who cannot afford copays for doctor or outpatient PT appointments.● Patients in urban communities whose mobility issues make leaving home difficult.● Patients whose inability to take time off work or secure childcare limits in-person visits.● Patients who speak English as a second language.Healthcare IT News interviewed physical therapist buy levitra in canada Bronwyn Spira, founder and CEO of Force Therapeutics, to discuss the challenges and opportunities surrounding this area of virtual care.Q. Why are minority and lower-income populations buy levitra in canada less likely to have orthopedic surgery – and more likely to experience poor outcomes when they do?. A. Musculoskeletal disorders are extremely common in buy levitra in canada our country.

At least 60% of American adults are affected by a musculoskeletal disorder, and more than 75% of those 65 and older are living with at least one musculoskeletal condition, which ranges from tendonitis to arthritis, degenerative disc disease, and chronic lower back pain.Lower-income and minority populations face multiple barriers to accessing the right healthcare and are typically less buy levitra in canada likely to utilize orthopedic care, which can result in significant functional impairment. Untreated musculoskeletal conditions also can result in sedentary behaviors that lead to or worsen comorbidities such as diabetes, obesity and depression.In one study of more than 7,000 individuals with arthritis, the incidence rates of developing disabilities in activities of daily living (ADL) over a six-year period were significantly higher for Blacks (28%) and Spanish-speaking Hispanics (28.5%) as compared to whites buy levitra in canada (16.2%).As I mentioned, disadvantaged populations often lack sufficient access to care, which can manifest in a few different ways. Many cannot afford the financial burden of co-pays, childcare, transportation, time off work or the out-of-pocket cost of receiving care when uninsured.The Commonwealth Fund found that 50% of low-income adults in the U.S. Skipped at least one buy levitra in canada medical visit, test, treatment or prescription per year due to its cost.Patients with state-funded Medicaid and federally funded Medicare plans also encounter logistical barriers to securing musculoskeletal care, including lower referral rates to orthopedic surgeons. Orthopedic specialists are 13% less likely to accept new Medicaid patients than they are Medicare patients or those with commercial insurance plans.Lastly, more than a third of Americans (36%) have low health literacy, which can be defined as the degree to which individuals can obtain, buy levitra in canada process and understand health information.

Older age, minority membership and low socioeconomic status are disproportionately correlated with poor functional health literacy in both urban and rural populations.Language barriers also impact care utilization and success rates, as individuals who cannot fully understand the directions they are buy levitra in canada given will not be able to adhere to a care plan. One study on healthcare utilization among Hispanic adults found that limited English proficiency contributes to the underuse of medical services.For all of these reasons, members of disadvantaged populations are far less likely to have orthopedic surgery to correct their musculoskeletal conditions. The data also indicates stark disparities in orthopedic care utilization among racial buy levitra in canada and ethnic minority groups.Researchers have found that even after adjustments are made for age, sex and income, Black patients are 30% less likely to receive a total hip or knee replacement than white patients.A systematic review of the literature reveals that members of minority populations who do have joint replacement surgery also are at a higher risk for early complications within the first 90 days, leading to higher hospital readmission rates.While there is no consensus as to the cause of these disparities, research suggests that multiple comorbidities, lower income, poor health literacy, provider bias and insufficient interventions are contributing factors.Q. How does offering remote buy levitra in canada education and remote physical therapy to patients improve access for vulnerable populations?. A.

First and foremost, remote education and physical therapy platforms reduce the need for patients to attend appointments in person. When hospitals, health systems and ambulatory surgical centers (ASCs) implement care management and remote monitoring tools, they set the stage for achieving greater health equity by removing some of the physical barriers to care.At the start of a surgical episode, for example, replacing preoperative in-person appointments with virtual education classes means that patients can get all the information they need to prepare for surgery without leaving the house.Educating patients about what they can expect for their surgery – including what outcomes are typical, and how long their healing will take – helps them set appropriate goals for their recovery.All remote education content must be tailored to the patient and their condition, and ideally should reflect their comorbidities, medication and social determinants of health, as these factors influence how a patient is likely to respond to treatment.Content should be delivered in the patient's native language, and should feature clear and easily understood directions. Engaging a care partner who can support the patient's recovery journey also can be extremely beneficial. Many patients find it helpful to return to valuable content as questions arise, and care partners can assist by reinforcing the care team's instructions along the way.Content also should be easily digestible and should arrive at the appropriate point in the patient's journey, so as not to overwhelm patients with too much information.For example, before surgery, patients need information about how long they will be out of commission and how to prepare their space for moving around with an assistive device. A few days after surgery, they need information on how to manage their swelling and control their pain.Many hospitals and ASCs also are offering patients the option of virtual PT to supplement or replace traditional outpatient PT, as remote therapy delivers similar results at a much lower opportunity cost for the patient.Randomized trials have shown that virtual PT produces similar outcomes to outpatient PT after total knee and hip arthroplasty procedures, as long as the virtual program is prescribed by the treating clinical team.In addition to the time savings involved, replacing traditional PT with remote PT can save patients hundreds of dollars in copays and convenience, as patients can complete the rehab in their own home at a convenient time.Q.

How does telehealth technology serve as a digital bridge to, for example, patients who cannot afford copays for doctor or outpatient PT appointments, patients in urban communities whose mobility issues make leaving home difficult, patients whose inability to take time off work or secure childcare limits in-person visits, and patients who speak English as a second language?. A. Digital therapeutics can help orthopedic teams build stronger relationships with their patients, especially those who are members of disadvantaged populations and who are likely to need additional support.Standardizing patient access to preoperative and postoperative education through remote technology can help practices correct against implicit bias and ensure consistent communication with all patient populations, including the 13% of Americans who speak Spanish at home.For patients living in rural communities, telehealth tools can close the access gap imposed by geography. For patients in urban areas, who may struggle to use public transportation or navigate the stairs in a fifth-floor walk-up, telehealth tools can mean the difference between skipping necessary appointments and following their care plan.Ideally, telehealth technology can serve as a digital bridge to connect vulnerable patients to their care teams. However, the infrastructure of any such tool must support all patient populations, including the 43% of lower-income adults without broadband services at home.In many low-income communities, insufficient access to a computer also hinders the use of digital care management and remote monitoring solutions.

Applications must compensate for the digital divide in their system design to ensure content does not require internet access, which can be poor or non-existent in certain areas.Patients should be able to access their care plans via mobile device with a secure login.According to the Pew Research Center, 27% of adults living in households earning less than $30,000 a year are smartphone-only internet users.As disadvantaged populations are far less likely to own a tablet, laptop or desktop computer, telehealth tools must be mobile-friendly and SMS-enabled. Two-way text messaging between patients and clinicians is a proven health intervention tool, as patients are much more likely to read and respond to a text than an email.Direct messaging via telehealth platforms also can improve outcomes for disadvantaged populations. When postoperative patients have a question about their pain levels, they can text their care team for answers instead of making an unnecessary trip to urgent care or the ER – or simply ignoring the problem until later, when interventions are less likely to be successful.Research shows that providing a care management platform with direct messaging decreases readmission rates across musculoskeletal procedures.Q. On a personal note, how does telehealth help you, the provider, with all these challenges?. A.

Early on in my career as a physical therapist, I managed and founded a number of orthopedics and sports medicine clinics in New York. My colleagues and I were constantly frustrated by how basic patient challenges – from inadequate healthcare access to poor health literacy and a lack of motivation – impacted our patients' outcomes.Similarly, we had very little or no visibility into how patients were managing at home, and whether the patients were achieving the outcomes that mattered to them. There wasn't a reliable closed-loop connection that provided the data we needed to make the right care decisions. Many patients would drop out of a treatment regimen due to access or cost challenges.There often were protracted gaps in care, and by the time the patient returned for treatment, they had often regressed or developed complications.That period led me to believe that evidence-based remote therapy and education could play a pivotal role in helping disadvantaged populations follow their postoperative care plan.In the traditional system, clinicians spend much of their valuable time in preoperative education visits, repeating the same things over and over to patients who are not likely to retain the bulk of this information. After surgery, nurses and care coordinators then work overtime to return patients' phone calls and fill in the knowledge gaps for patients.Digital care management systems allow orthopedic practices to scale valuable in-person time by automating low-touch interactions, while identifying the patients who need targeted one-to-one intervention.

With the benefit of technology, practices can create high-value, repeatable workflows to fully prepare patients for surgery by giving patients what they need to know as they need to know it.This phased, segmented approach to education has been proven to correct for the retention gap of in-person education.The addition of patient messaging and remote monitoring tools enables the delivery of patient-reported outcomes data and care plan progression feedback to be returned in real time to the care team, who then can intervene as necessary.Orthopedic practices are much less likely to miss a patient who has stalled in their recovery and is at a high risk of developing complications. When digital therapeutics are designed to be inclusive of all patient populations, they can transform the way we practice orthopedics to improve health equity.Twitter. @SiwickiHealthITEmail the writer. Bsiwicki@himss.orgHealthcare IT News is a HIMSS Media publication..

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India’s Karuna Trust has achieved a digital health milestone, becoming the first healthcare provider in the nation to buying levitra online safe achieve HIMSS O-EMRAM Stage 6 for the technology integrations at its Tavarekere Urban Primary Health Center in Bengaluru.WHY IT MATTERSKaruna Trust joins a group of organisations across the globe that are committed to operating in a near paperless environment while using electronic patient record technology to drive improvements in all aspects of ambulatory care.Congratulating Karuna Trust on its "incredible efforts", HIMSS Regional Director for Europe, the Middle East and Africa John Rayner, said the outcome was the result of the "hard work and dedication" of the clinical team, who worked alongside colleagues from EMR provider Cerner to complete the Outpatient Electronic Medical Record Adoption Model assessment."On being validated at Stage 6 you are clearly demonstrating your ongoing commitment to improving patient safety and the overall quality of clinical care through the effective use and deployment of electronic medical record technology," Rayner said.Tavarekere UPHC was commended for an integrated system that allows all doctors, nurse practitioners and allied health professionals to document their patients' care. Devices for measuring blood pressure, temperature, heart rate and oxygen saturation all directly interface with the EMR, which also records the majority of blood tests and imaging examinations.The digital system allows staff to use clinical decision support in erectile dysfunction treatment triage, symptom tracking and care pathways, and provides drug-allergy checks, dose range alerts and buying levitra online safe duplicate therapy alerts. A messaging system is used for clinical consults, internal communications and patient reminders.THE LARGER CONTEXTThe O-EMRAM is used to assess EMR implementation for the outpatient services of hospitals and health systems, guiding the data-driven advancement of care outside the walls of the acute care setting.Most recently in December last year, Dr Soliman Fakeeh Hospital achieved Stage 7 EMRAM, which is the highest level of validation for the model.New O-EMRAM standards will be released in 2022, with the system being broadened to include assessments of remote and virtual care, and patient engagement, while providers will be required to demonstrate improved clinical outcomes.ON THE RECORDDentist Dr Komal S. Naik from Tavarekere UPHC described it as a "proud buying levitra online safe moment" and recognition of a determined effort to harness digital technologies to improve healthcare for underprivileged populations in India."It is a great achievement and a proud moment to be part of it.

We were thrilled when we got to know that we cleared the assessment," Dr Naik said."Karuna Trust aims at making Tavarekere UPHC a model health centre so we wanted to improve the standards of the hospital and digitise the centre to keep up with the modern advancements in the healthcare sector."One of the most significant issues facing healthcare provider organizations today regards the accuracy of patient records. Healthcare facilities often fail to buying levitra online safe link records for the same patient. Such challenges can be costly to providers and patients.Add to that the emergence of testing and vaccination centers during the levitra. These centers are anywhere buying levitra online safe and everywhere.

How does matching patient records function in this makeshift environment?. Healthcare IT News sat down with Clay Ritchey, CEO of Verato, a vendor of patient-matching technology, to talk about how buying levitra online safe patient matching technologies can help healthcare providers overcome the clinical and financial challenges posed by inaccurate patient records, particularly during the levitra, as well as about their potential to improve healthcare delivery by tracking social determinants of health.Q. How can providers address challenges around patient-record duplication and matching at testing and vaccination centers? buying levitra online safe. A.

There is no question that patient identity and record matching are critical to fighting the erectile dysfunction treatment levitra, especially as they relate to contact tracing and buying levitra online safe treatment deployment. Public health experts rely on patient data contained in disparate hospital, clinic and laboratory electronic health record systems to help determine testing, vaccination and care status of the U.S. Population.Unfortunately, EHRs are only as helpful as their buying levitra online safe ability to talk to each other. The fact is that healthcare facilities fail to link records for the same patient as often as half the time.

A recent Duke-Margolis study also found that as much as 50% of erectile dysfunction treatment laboratory reports buying levitra online safe prepared early on in the levitra were missing addresses or ZIP codes, preventing many patients and their physicians from receiving their test results.Identity resolution, or patient matching, solutions can without doubt help improve patient-matching rates. However, many such solutions are based solely on algorithms and probability, and research shows that relying only on these matching methods achieves accuracy rates of only about 65%. This means any given provider's patient buying levitra online safe records are inaccurate for about one out of every three patients.Fortunately, new technology based on referential databases of records on virtually every U.S. Citizen is becoming available, with automated patient-matching accuracy rates as high as 98%.

This level of patient matching performance coupled with modern cloud-based services to ease the interoperability challenges has the potential to dramatically improve the country's ability to track erectile dysfunction treatment testing and vaccination, as well as increase patient data accuracy and reduce duplicate records across healthcare facilities.It also buying levitra online safe can enable healthcare providers to match a patient's medical records to additional data about them, like social determinants of health, to provide a complete picture of each person and ultimately better care.With complete data on patients, providers also can aggregate better population data and run analytics that show, for instance, whether the organization is disproportionately providing care to certain segments of the population and give clues as to how to address health inequities.Q. You've said that poor patient matching buying levitra online safe is not only a healthcare risk, but that it also raises costs. How so?. And what can provider organizations buying levitra online safe do to prevent this?.

A. Poor patient-matching buying levitra online safe capabilities are costly. According to one survey, patient-matching issues cost an average of $1,950 per patient per inpatient stay, and more than $800 per ED visit. The survey also found an estimated 33% of buying levitra online safe all denied claims resulted from inaccurate patient identification or incorrect patient information.Claims denied for these reasons cost the average hospital $1.5 million in 2017 and the U.S.

Healthcare system more than $6 billion annually. There is even a report that the care for an 11-month-old twin was documented in her sister's healthcare record, costing the health system $43,000 in unreimbursed payments.Clearly, the ability to accurately match patients with their data is critical to every provider and payer's business success, especially considering that fee-for-service payment models have steadily declined as value-based models rise buying levitra online safe in popularity. Succeeding in this environment, where organizations are paid buying levitra online safe based on patient outcomes and quality of their care, requires not only a thorough understanding of any given patient, but also any given patient population.Providers must be able to identify those at risk for chronic conditions and proactively manage them. But they cannot do that, at least not efficiently or cost-effectively, if patients cannot be accurately matched to their data.Another thing to keep in mind is that the healthcare system is becoming increasingly consumer-focused.

People now expect to interact with their healthcare providers the same way they interact with their banks, utilities and e-commerce companies.They are tired of filling out the same forms at every encounter and they want seamless, easy, virtual access to their data and services, no matter where they receive care – their family doctor's office, their specialist's office, a telehealth visit, an urgent care center in their town or a hospital in another state while on vacation.Patients are no longer hesitant buying levitra online safe to jump ship for another provider who can give them what they want. And one of the best ways to acquire, engage and keep them is to show patients that you know them. Accurate identity-matching tools give providers the ability to do that – curate and cost-effectively buying levitra online safe deliver the specific information and services required by each patient across their care journey.Q. What power can clean, properly matched health data bring to social determinants of health?.

A. High-quality healthcare delivery is no longer just a matter of knowing what chronic diseases or conditions a patient has, treating them accordingly and sending them on their way. It's also important to know what issues they deal with outside of their health – their level of education, access to transportation, whether they are experiencing food insecurity or unemployment, their income, and more.All of these play into their provider's ability to treat them, as well as their ability to comply with treatment and other aspects of their care.Beyond building a complete and trusted picture of patients, enriching accurate EHR patient data with SDOH and identity information management can support patients by giving healthcare organizations the right context to reach at-risk individuals, anticipate outbreaks and ensure equitable outcomes.As I alluded to previously, this is vital to contact tracing, analytics and outreach efforts in the levitra, and will continue to play a critical role in healthcare delivery far into the future.Moreover, incorporating that information into the EHR can help to ensure that no matter where a patient may be at any given time, all their information can be holistically available to the patient or their clinician to help them make better choices, whether they be reactive in the moment or proactive to help provide for good, long-term care coordination to patients with or at risk for chronic diseases.Twitter. @SiwickiHealthITEmail the writer.

Bsiwicki@himss.orgHealthcare IT News is a HIMSS Media publication.In the U.S. Government Accountability Office's ninth comprehensive report on the erectile dysfunction treatment levitra this week, the watchdog said "significant improvements are needed" when it comes to public health emergency response. The GAO zeroed in on the U.S. Department of Health and Human Services' leadership in particular, announcing that it was adding the agency to its "High Risk List.""For over a decade, we have found issues with how HHS' leadership prepares for and responds to emergencies, including erectile dysfunction treatment, other infectious diseases, and extreme weather events, such as hurricanes," wrote the watchdog in its report on Thursday.

WHY IT MATTERS The GAO's "high risk" list comprises programs and operations that it defines as "vulnerable to waste, fraud, abuse, or mismanagement, or in need of transformation."Over the course of more than a decade, GAO had made 115 recommendations to HHS related to its response to public health emergencies. Of these, only 33 have been implemented, and 10 have been closed. The remaining 72 are outstanding – and 49 of those relate to the erectile dysfunction treatment levitra. The watchdog notes that it named HHS' leadership and coordination of public health emergencies as an emerging issue requiring close attention in March 2021.

GAO highlighted several "persistent deficiencies" in key areas, including. Establishing clear roles and responsibilities for federal, state, local, tribal, territorial and nongovernmental partners Collecting and analyzing complete and consistent data to inform decision-making, including any midcourse changes, as well as future preparednessProviding clear, consistent communication to key partners and the publicEstablishing transparency and accountability to help ensure program integrity and build public trustUnderstanding key partners’ capabilities and limitations The watchdog drew particular attention to supply chain issues, noting that HHS has not addressed its September 2020 recommendation that the department work with the Federal Emergency Management Agency to develop mitigation response plans for the remainder of the levitra.It also targeted the "incomplete and inconsistent" data HHS has relied on throughout the levitra to respond to public health emergencies.erectile dysfunction treatment testing, case counts and hospital capacity data have been challenging to interpret due to gaps in collection, said GAO. In addition, it pointed to race and ethnicity data regarding erectile dysfunction treatment, saying that shortcomings in data "limited the nation’s ability to effectively target levitra response efforts" for disproportionately affected groups.Nursing home data got a mention too. "By not requiring nursing homes to submit data from the first 4 months of 2020, HHS limited the usefulness of the data in helping to understand the effects of erectile dysfunction treatment in nursing homes during the initial stage of the response." Overall, the fragmented nature of public health reporting has contributed to struggles with information sharing.

"Under the existing process – which HHS has had to rely on during the erectile dysfunction treatment levitra – public health data are collected by thousands of different health departments and laboratories, as well as multiple federal agencies," said the GAO report. "Technological capabilities vary widely among these entities, which may use systems and software that are not interoperable and unable to exchange and share data," it continued. The GAO said that it would evaluate HHS' efforts to address public health emergencies against its "high-risk criteria." "By taking actions to enhance its leadership and coordination of public health emergencies, HHS will be better positioned to help the nation more effectively prepare for, and respond to, future public health emergencies in a timely and effective manner," said the report. THE LARGER TREND Data collection has been a recurrent issue since the start of the levitra, with the former presidential administration triggering anxiety and confusion when it directed hospitals to report erectile dysfunction treatment information to HHS rather than the U.S.

Centers for Disease Control and Prevention. In November 2020, former HHS Chief Technology Officer Ed Simcox told Healthcare IT News that the crisis made it clear that the gaps in U.S. Information sharing must be addressed. And at HIMSS in August 2021, National Coordinator for Health IT Micky Tripathi and Dr.

Daniel Jernigan, acting deputy director for public health science and surveillance at the CDC, agreed that overcoming data-sharing barriers is essential.But the Biden administration has still faced hurdles where agency leadership is concerned. Food and Drug Administration Commissioner Robert Califf is reportedly in "limbo" in the Senate, with a lack of enough votes to push his nomination through.ON THE RECORD "As devastating as the erectile dysfunction treatment levitra has been, more frequent extreme weather events, new levitraes, and bad actors who threaten to cause intentional harm loom, making the deficiencies GAO has identified particularly concerning," read this week's GAO report. "Not being sufficiently prepared for a range of public health emergencies can also negatively affect the time and resources needed to achieve full recovery." Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail.

Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.The 2021 edition was visibly quieter in comparison to pre-levitra years. However, the just-concluded Arab Health 2022 showed that the region is very much back to (healthcare) business.Taking place 24-27 January alongside Medlab Middle East at the Dubai World Trade Centre, Arab Health 2022 was a much busier affair, welcoming around 4,000 exhibitors from more than 60 countries, and a projected combined 60,000 attendees.We’ve rounded up the top UAE and GCC-focused headlines, in no particular order, for easy reading. 1. Mubadala Health announces Dubai entryMubadala Health – the new brand born out of Abu Dhabi’s Mubadala Healthcare last year – announced its plans to enter Dubai, with its first facility already in progress.Taking place in collaboration with the Dubai Health Authority (DHA) and the Ministry of Health &.

Prevention (MoHAP), the company’s first project will be a 11,600 sqm Jumeirah-based “advanced stand-alone day surgery and medical facility” set to launch in Q3 2022.“Mubadala Health’s plan will help achieve the common national goals of improving the efficiency and competitiveness of the UAE health sector, and consolidating the country’s position as a leading destination for innovative health care, something which will reflect positively on realising the sustainable development goals,” said Abdul Rahman bin Mohammad bin Nasser Al Owais, Minister of Health and Prevention, during the announcement at Arab Health 2022. 2. €œWorld’s first healthcare metaverse platform” launchedEmirates Health Services (EHS) launched what it is calling the “world’s first healthcare metaverse platform”, reportedly offering a solution particularly helpful for those unable to physically commute to a clinic or hospital.Currently in pilot stage, MetaHealth offers a virtual world of “doctors, health professionals, or representatives of three major hospitals in Dubai”. Patients only need a smart device to access the platform.EHS also announced three new tech-focused products at the conference.

3. Another metaverse first by MoHAPIn keeping with the theme of virtual firsts, MoHAP unveiled its virtual customer services centre, which it is dubbing the “world’s first metaverse customer happiness service centre”.The full version is expected to arrive by mid-2022. 4. Paperless medication trialledMoHAP also showcased an “AR-powered” paperless medication packs project which aims to link packaging to updated drug information online.

Patients can become “interactive” with the information through a virtual assistant.The ministry said that the new project was to “enhance access to drug-related information in an easy and innovative way,” as well as “improve treatment outcomes and avoid medication errors”. 5. Homegrown healthtech venture KLAIM to receive up to $50M from Alkhair CapitalKLAIM, the Dubai-based insurtech platform, has signed an MoU with Alkhair Capital Saudi Arabia to “launch investment products worth $50 million to support healthcare providers in the Middle East and North Africa [MENA]” region.“In light of the challenges faced by the healthcare sector related to cash flows from medical insurance service providers, KLAIM has effectively found the best innovative solutions to these challenges,” said Alkhair Capital MD and CEO, Khalid Al-Mulhem. €œWe believe in the ability of these solutions to revolutionise the MENA region’s healthcare and fintech industry and we are delighted to give our investors an opportunity to invest in this new revolution and support the growth of fintech and healthcare.”In September 2021, MobiHealthNews reported that KLAIM had raised an additional $1.6 million in funding as part of plans to expand into Saudi Arabia and the United States.

6. UK’s King’s College Hospital announces second GCC entryKing’s College Hospital London (KCHL) – along with Ashmore Group and Saudi Bugshan Group – announced the launch of King’s College Hospital Jeddah (KCHJ), the first hospital by the UK institution in the Kingdom of Saudi Arabia.The 32,000 sqm hospital is scheduled to open in the second half of 2023.KCHL’s most recent launch in the region was in the UAE, with the opening of its first fully integrated hospital in Dubai in 2019. It also has other clinics and centres in Dubai and Abu Dhabi. 7.

Health monitoring and surveillance tech showcasedWith governments keen to avoid a repeat of the erectile dysfunction treatment levitra, the UAE’s MoHAP also launched and showcased disease monitoring and surveillance solutions at Arab Health 2022.First up, SPHERE is an “e-platform for epidemiological surveillance and management that can be used or linked at the state level,” to share and exchange information pertaining to potential threats.The ministry said that SPHERE aims to “provide an integrated system for early monitoring, follow-up, and management of events affecting public health and strengthen linkage with the government and private health sectors and other stakeholders.”Its second project is a reported AI-powered Digital Health Monitoring Centre that can “curb the spread of communicable diseases based on the data of international organisations such as the World Health Organisation [WHO] and the Center for Disease Control and Prevention [CDC].” 8. New R&D labs for local healthcare research and manufacturingDubai Science Park (DSP) is set to launch three new research and development (R&D) laboratories this year, reported Gulf News.Marwan Abdul Aziz Al Janahi, MD for DSP, told the UAE daily that the park has “nurtured” over 4,000 healthcare related professionals to pursue R&D and manufacturing. He added that activities taking place at DSP include treatment research and manufacture, medicine and healthcare equipment production, and genomic research. 9.

Abu Dhabi and Israel to explore bio-convergenceThe Department of Health – Abu Dhabi (DoH) and the Israel Innovation Authority (IIA) announced they are to collaborate on health innovation, with a particular focus on bio-convergence.A relatively new term within healthcare and life science research, bio-convergence is defined as the “synergy between engineering/technology and computerised systems”.Dror Bin, CEO of IIA, stated. €œThe agreement between the IIA and the DoH – Abu Dhabi is a unique opportunity to leverage Abu Dhabi’s advanced and booming healthtech ecosystem and Israel's innovation capabilities in the area of healthcare.“It is also an opportunity to advance a multidisciplinary innovative approach of bio-convergence – merging between the field of life sciences and medical technologies and engineering and AI.” 10. New ECG app authorised in UAEThe MoHAP also announced its authorisation of a new (ECG) application that reportedly provides 95% accurate, instant results.Produced with ProCardio Medical Equipment Company, this new app can apparently be used to “accurately and quickly read, analyse, and diagnose the patient's condition, which would be particularly important in dealing with critical cases, such as cardiac arrhythmia.”EMR platform Docon Technologies by digital health company API Holdings has received government approval to integrate with the Ayush Bharat Health Account, the health ID component of the Ayush Bharat Digital Mission. Docon helps in digitising healthcare practices by enabling care provision via virtual clinics.

It offers a patient health record management system that empowers better diagnosis. Through its type-free interface and learning algorithms, it is able to quickly generate a prescription. The company also does home delivery of medicines and diagnostics in partnership with digital pharmacies and diagnostics providers.WHY IT MATTERSThe digital clinic is among the country's first providers to adopt and enable the government's ABHA. The health ID is a way for patients to create their digital health records and to access and share these data with their care providers and payers.

It also allows them to receive digital lab reports, prescriptions, and diagnoses from verified medical professionals. The ABHA ultimately enables doctors and patients to seamlessly connect within the Indian digital health ecosystem."Just as UPI (Unified Payments Interface) and online payments changed the way consumers transact, health ID-enabled Docon will change the way doctors and patients interact, providing deep patient health history and understanding to the doctors, allowing them to deliver the best patient outcome," Akash Valia, head of Docon, said about their platform's integration with ABHA.THE LARGER CONTEXTIn August, the government launched the ABDM, which aims to build the digital infrastructure of India's healthcare system. This digital ecosystem consists of the following. Digital health ID, doctor registry, health facility registry, personal health record and electronic health record.

Early this month, the National Health Authority said it will proceed to develop the Unified Health Interface (UHI), an open network for interoperable digital health services. A core component of the ABDM, the UHI will adopt an open protocol to ensure interoperability..

India’s Karuna Trust has achieved a digital health milestone, becoming the first healthcare provider in the nation to achieve HIMSS O-EMRAM Stage 6 for the technology integrations at its Tavarekere Urban Primary Health Center in Bengaluru.WHY IT MATTERSKaruna Trust joins a group of organisations across the globe that are committed to operating in a near paperless environment while using electronic patient record technology to drive improvements in all aspects of ambulatory care.Congratulating Karuna Trust on its "incredible efforts", HIMSS Regional Director for Europe, the Middle East and Africa John Rayner, said the outcome was the result of the "hard work and dedication" of the clinical team, who worked alongside colleagues from EMR provider Cerner to complete the Outpatient Electronic Medical Record Adoption Model assessment."On being validated at Stage 6 you are clearly demonstrating your ongoing commitment to improving patient safety and the overall quality of clinical care through the effective use and deployment of electronic medical record technology," Rayner said.Tavarekere UPHC was commended for an buy levitra in canada integrated system that allows all doctors, nurse practitioners and allied health professionals to document their patients' care. Devices for measuring blood pressure, temperature, heart rate and oxygen saturation all directly interface with the EMR, which also records the majority of blood tests and imaging examinations.The digital system allows staff to use clinical decision support in erectile dysfunction treatment triage, symptom tracking and care pathways, buy levitra in canada and provides drug-allergy checks, dose range alerts and duplicate therapy alerts. A messaging system is used for clinical consults, internal communications and patient reminders.THE LARGER CONTEXTThe O-EMRAM is used to assess EMR implementation for the outpatient services of hospitals and health systems, guiding the data-driven advancement of care outside the walls of the acute care setting.Most recently in December last year, Dr Soliman Fakeeh Hospital achieved Stage 7 EMRAM, which is the highest level of validation for the model.New O-EMRAM standards will be released in 2022, with the system being broadened to include assessments of remote and virtual care, and patient engagement, while providers will be required to demonstrate improved clinical outcomes.ON THE RECORDDentist Dr Komal S. Naik from Tavarekere UPHC described it as a "proud moment" and recognition of a determined effort to harness digital buy levitra in canada technologies to improve healthcare for underprivileged populations in India."It is a great achievement and a proud moment to be part of it. We were thrilled when we got to know that we cleared the assessment," Dr Naik said."Karuna Trust aims at making Tavarekere UPHC a model health centre so we wanted to improve the standards of the hospital and digitise the centre to keep up with the modern advancements in the healthcare sector."One of the most significant issues facing healthcare provider organizations today regards the accuracy of patient records.

Healthcare facilities buy levitra in canada often fail to link records for the same patient. Such challenges can be costly to providers and patients.Add to that the emergence of testing and vaccination centers during the levitra. These centers are buy levitra in canada anywhere and everywhere. How does matching patient records function in this makeshift environment?. Healthcare IT News sat down with Clay Ritchey, CEO of Verato, a vendor of patient-matching buy levitra in canada technology, to talk about how patient matching technologies can help healthcare providers overcome the clinical and financial challenges posed by inaccurate patient records, particularly during the levitra, as well as about their potential to improve healthcare delivery by tracking social determinants of health.Q.

How can buy levitra in canada providers address challenges around patient-record duplication and matching at testing and vaccination centers?. A. There is no question that patient buy levitra in canada identity and record matching are critical to fighting the erectile dysfunction treatment levitra, especially as they relate to contact tracing and treatment deployment. Public health experts rely on patient data contained in disparate hospital, clinic and laboratory electronic health record systems to help determine testing, vaccination and care status of the U.S. Population.Unfortunately, EHRs buy levitra in canada are only as helpful as their ability to talk to each other.

The fact is that healthcare facilities fail to link records for the same patient as often as half the time. A recent Duke-Margolis study also found that as much as 50% of erectile dysfunction treatment laboratory reports prepared early on in the levitra were missing addresses or ZIP codes, preventing many patients and their physicians from receiving their test results.Identity resolution, or patient matching, solutions buy levitra in canada can without doubt help improve patient-matching rates. However, many such solutions are based solely on algorithms and probability, and research shows that relying only on these matching methods achieves accuracy rates of only about 65%. This means any buy levitra in canada given provider's patient records are inaccurate for about one out of every three patients.Fortunately, new technology based on referential databases of records on virtually every U.S. Citizen is becoming available, with automated patient-matching accuracy rates as high as 98%.

This level of patient matching performance coupled with modern cloud-based services to ease the interoperability challenges has the potential to dramatically improve the country's ability to track erectile dysfunction treatment testing and vaccination, as well as increase patient data accuracy and reduce duplicate records across healthcare facilities.It also can enable healthcare providers to match a patient's medical records to additional data about them, like social determinants of health, to provide a complete picture of each person and ultimately better care.With complete data on patients, providers also can aggregate better buy levitra in canada population data and run analytics that show, for instance, whether the organization is disproportionately providing care to certain segments of the population and give clues as to how to address health inequities.Q. You've said that poor patient matching is not only a healthcare risk, but that it also raises buy levitra in canada costs. How so?. And what can provider organizations do to prevent this? buy levitra in canada. A.

Poor patient-matching capabilities are buy levitra in canada costly. According to one survey, patient-matching issues cost an average of $1,950 per patient per inpatient stay, and more than $800 per ED visit. The survey also found an estimated 33% buy levitra in canada of all denied claims resulted from inaccurate patient identification or incorrect patient information.Claims denied for these reasons cost the average hospital $1.5 million in 2017 and the U.S. Healthcare system more than $6 billion annually. There is even a report that the care for an 11-month-old twin was documented in her sister's healthcare record, costing the health system $43,000 in unreimbursed payments.Clearly, buy levitra in canada the ability to accurately match patients with their data is critical to every provider and payer's business success, especially considering that fee-for-service payment models have steadily declined as value-based models rise in popularity.

Succeeding in this environment, where organizations are paid based on patient outcomes and quality of their care, requires not only a thorough understanding of any given buy levitra in canada patient, but also any given patient population.Providers must be able to identify those at risk for chronic conditions and proactively manage them. But they cannot do that, at least not efficiently or cost-effectively, if patients cannot be accurately matched to their data.Another thing to keep in mind is that the healthcare system is becoming increasingly consumer-focused. People now expect to interact with their healthcare providers the same way they interact with their banks, utilities and e-commerce companies.They are tired of filling out the same forms at every encounter and they want seamless, easy, virtual access to their data and services, no matter where they receive care – their buy levitra in canada family doctor's office, their specialist's office, a telehealth visit, an urgent care center in their town or a hospital in another state while on vacation.Patients are no longer hesitant to jump ship for another provider who can give them what they want. And one of the best ways to acquire, engage and keep them is to show patients that you know them. Accurate identity-matching tools give providers the ability to buy levitra in canada do that – curate and cost-effectively deliver the specific information and services required by each patient across their care journey.Q.

What power can clean, properly matched health data bring to social determinants of health?. A. High-quality healthcare delivery is no longer just a matter of knowing what chronic diseases or conditions a patient has, treating them accordingly and sending them on their way. It's also important to know what issues they deal with outside of their health – their level of education, access to transportation, whether they are experiencing food insecurity or unemployment, their income, and more.All of these play into their provider's ability to treat them, as well as their ability to comply with treatment and other aspects of their care.Beyond building a complete and trusted picture of patients, enriching accurate EHR patient data with SDOH and identity information management can support patients by giving healthcare organizations the right context to reach at-risk individuals, anticipate outbreaks and ensure equitable outcomes.As I alluded to previously, this is vital to contact tracing, analytics and outreach efforts in the levitra, and will continue to play a critical role in healthcare delivery far into the future.Moreover, incorporating that information into the EHR can help to ensure that no matter where a patient may be at any given time, all their information can be holistically available to the patient or their clinician to help them make better choices, whether they be reactive in the moment or proactive to help provide for good, long-term care coordination to patients with or at risk for chronic diseases.Twitter. @SiwickiHealthITEmail the writer.

Bsiwicki@himss.orgHealthcare IT News is a HIMSS Media publication.In the U.S. Government Accountability Office's ninth comprehensive report on the erectile dysfunction treatment levitra this week, the watchdog said "significant improvements are needed" when it comes to public health emergency response. The GAO zeroed in on the U.S. Department of Health and Human Services' leadership in particular, announcing that it was adding the agency to its "High Risk List.""For over a decade, we have found issues with how HHS' leadership prepares for and responds to emergencies, including erectile dysfunction treatment, other infectious diseases, and extreme weather events, such as hurricanes," wrote the watchdog in its report on Thursday. WHY IT MATTERS The GAO's "high risk" list comprises programs and operations that it defines as "vulnerable to waste, fraud, abuse, or mismanagement, or in need of transformation."Over the course of more than a decade, GAO had made 115 recommendations to HHS related to its response to public health emergencies.

Of these, only 33 have been implemented, and 10 have been closed. The remaining 72 are outstanding – and 49 of those relate to the erectile dysfunction treatment levitra. The watchdog notes that it named HHS' leadership and coordination of public health emergencies as an emerging issue requiring close attention in March 2021. GAO highlighted several "persistent deficiencies" in key areas, including. Establishing clear roles and responsibilities for federal, state, local, tribal, territorial and nongovernmental partners Collecting and analyzing complete and consistent data to inform decision-making, including any midcourse changes, as well as future preparednessProviding clear, consistent communication to key partners and the publicEstablishing transparency and accountability to help ensure program integrity and build public trustUnderstanding key partners’ capabilities and limitations The watchdog drew particular attention to supply chain issues, noting that HHS has not addressed its September 2020 recommendation that the department work with the Federal Emergency Management Agency to develop mitigation response plans for the remainder of the levitra.It also targeted the "incomplete and inconsistent" data HHS has relied on throughout the levitra to respond to public health emergencies.erectile dysfunction treatment testing, case counts and hospital capacity data have been challenging to interpret due to gaps in collection, said GAO.

In addition, it pointed to race and ethnicity data regarding erectile dysfunction treatment, saying that shortcomings in data "limited the nation’s ability to effectively target levitra response efforts" for disproportionately affected groups.Nursing home data got a mention too. "By not requiring nursing homes to submit data from the first 4 months of 2020, HHS limited the usefulness of the data in helping to understand the effects of erectile dysfunction treatment in nursing homes during the initial stage of the response." Overall, the fragmented nature of public health reporting has contributed to struggles with information sharing. "Under the existing process – which HHS has had to rely on during the erectile dysfunction treatment levitra – public health data are collected by thousands of different health departments and laboratories, as well as multiple federal agencies," said the GAO report. "Technological capabilities vary widely among these entities, which may use systems and software that are not interoperable and unable to exchange and share data," it continued. The GAO said that it would evaluate HHS' efforts to address public health emergencies against its "high-risk criteria." "By taking actions to enhance its leadership and coordination of public health emergencies, HHS will be better positioned to help the nation more effectively prepare for, and respond to, future public health emergencies in a timely and effective manner," said the report.

THE LARGER TREND Data collection has been a recurrent issue since the start of the levitra, with the former presidential administration triggering anxiety and confusion when it directed hospitals to report erectile dysfunction treatment information to HHS rather than the U.S. Centers for Disease Control and Prevention. In November 2020, former HHS Chief Technology Officer Ed Simcox told Healthcare IT News that the crisis made it clear that the gaps in U.S. Information sharing must be addressed. And at HIMSS in August 2021, National Coordinator for Health IT Micky Tripathi and Dr.

Daniel Jernigan, acting deputy director for public health science and surveillance at the CDC, agreed that overcoming data-sharing barriers is essential.But the Biden administration has still faced hurdles where agency leadership is concerned. Food and Drug Administration Commissioner Robert Califf is reportedly in "limbo" in the Senate, with a lack of enough votes to push his nomination through.ON THE RECORD "As devastating as the erectile dysfunction treatment levitra has been, more frequent extreme weather events, new levitraes, and bad actors who threaten to cause intentional harm loom, making the deficiencies GAO has identified particularly concerning," read this week's GAO report. "Not being sufficiently prepared for a range of public health emergencies can also negatively affect the time and resources needed to achieve full recovery." Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.The 2021 edition was visibly quieter in comparison to pre-levitra years.

However, the just-concluded Arab Health 2022 showed that the region is very much back to (healthcare) business.Taking place 24-27 January alongside Medlab Middle East at the Dubai World Trade Centre, Arab Health 2022 was a much busier affair, welcoming around 4,000 exhibitors from more than 60 countries, and a projected combined 60,000 attendees.We’ve rounded up the top UAE and GCC-focused headlines, in no particular order, for easy reading. 1. Mubadala Health announces Dubai entryMubadala Health – the new brand born out of Abu Dhabi’s Mubadala Healthcare last year – announced its plans to enter Dubai, with its first facility already in progress.Taking place in collaboration with the Dubai Health Authority (DHA) and the Ministry of Health &. Prevention (MoHAP), the company’s first project will be a 11,600 sqm Jumeirah-based “advanced stand-alone day surgery and medical facility” set to launch in Q3 2022.“Mubadala Health’s plan will help achieve the common national goals of improving the efficiency and competitiveness of the UAE health sector, and consolidating the country’s position as a leading destination for innovative health care, something which will reflect positively on realising the sustainable development goals,” said Abdul Rahman bin Mohammad bin Nasser Al Owais, Minister of Health and Prevention, during the announcement at Arab Health 2022. 2.

€œWorld’s first healthcare metaverse platform” launchedEmirates Health Services (EHS) launched what it is calling the “world’s first healthcare metaverse platform”, reportedly offering a solution particularly helpful for those unable to physically commute to a clinic or hospital.Currently in pilot stage, MetaHealth offers a virtual world of “doctors, health professionals, or representatives of three major hospitals in Dubai”. Patients only need a smart device to access the platform.EHS also announced three new tech-focused products at the conference. 3. Another metaverse first by MoHAPIn keeping with the theme of virtual firsts, MoHAP unveiled its virtual customer services centre, which it is dubbing the “world’s first metaverse customer happiness service centre”.The full version is expected to arrive by mid-2022. 4.

Paperless medication trialledMoHAP also showcased an “AR-powered” paperless medication packs project which aims to link packaging to updated drug information online. Patients can become “interactive” with the information through a virtual assistant.The ministry said that the new project was to “enhance access to drug-related information in an easy and innovative way,” as well as “improve treatment outcomes and avoid medication errors”. 5. Homegrown healthtech venture KLAIM to receive up to $50M from Alkhair CapitalKLAIM, the Dubai-based insurtech platform, has signed an MoU with Alkhair Capital Saudi Arabia to “launch investment products worth $50 million to support healthcare providers in the Middle East and North Africa [MENA]” region.“In light of the challenges faced by the healthcare sector related to cash flows from medical insurance service providers, KLAIM has effectively found the best innovative solutions to these challenges,” said Alkhair Capital MD and CEO, Khalid Al-Mulhem. €œWe believe in the ability of these solutions to revolutionise the MENA region’s healthcare and fintech industry and we are delighted to give our investors an opportunity to invest in this new revolution and support the growth of fintech and healthcare.”In September 2021, MobiHealthNews reported that KLAIM had raised an additional $1.6 million in funding as part of plans to expand into Saudi Arabia and the United States.

6. UK’s King’s College Hospital announces second GCC entryKing’s College Hospital London (KCHL) – along with Ashmore Group and Saudi Bugshan Group – announced the launch of King’s College Hospital Jeddah (KCHJ), the first hospital by the UK institution in the Kingdom of Saudi Arabia.The 32,000 sqm hospital is scheduled to open in the second half of 2023.KCHL’s most recent launch in the region was in the UAE, with the opening of its first fully integrated hospital in Dubai in 2019. It also has other clinics and centres in Dubai and Abu Dhabi. 7. Health monitoring and surveillance tech showcasedWith governments keen to avoid a repeat of the erectile dysfunction treatment levitra, the UAE’s MoHAP also launched and showcased disease monitoring and surveillance solutions at Arab Health 2022.First up, SPHERE is an “e-platform for epidemiological surveillance and management that can be used or linked at the state level,” to share and exchange information pertaining to potential threats.The ministry said that SPHERE aims to “provide an integrated system for early monitoring, follow-up, and management of events affecting public health and strengthen linkage with the government and private health sectors and other stakeholders.”Its second project is a reported AI-powered Digital Health Monitoring Centre that can “curb the spread of communicable diseases based on the data of international organisations such as the World Health Organisation [WHO] and the Center for Disease Control and Prevention [CDC].” 8.

New R&D labs for local healthcare research and manufacturingDubai Science Park (DSP) is set to launch three new research and development (R&D) laboratories this year, reported Gulf News.Marwan Abdul Aziz Al Janahi, MD for DSP, told the UAE daily that the park has “nurtured” over 4,000 healthcare related professionals to pursue R&D and manufacturing. He added that activities taking place at DSP include treatment research and manufacture, medicine and healthcare equipment production, and genomic research. 9. Abu Dhabi and Israel to explore bio-convergenceThe Department of Health – Abu Dhabi (DoH) and the Israel Innovation Authority (IIA) announced they are to collaborate on health innovation, with a particular focus on bio-convergence.A relatively new term within healthcare and life science research, bio-convergence is defined as the “synergy between engineering/technology and computerised systems”.Dror Bin, CEO of IIA, stated. €œThe agreement between the IIA and the DoH – Abu Dhabi is a unique opportunity to leverage Abu Dhabi’s advanced and booming healthtech ecosystem and Israel's innovation capabilities in the area of healthcare.“It is also an opportunity to advance a multidisciplinary innovative approach of bio-convergence – merging between the field of life sciences and medical technologies and engineering and AI.” 10.

New ECG app authorised in UAEThe MoHAP also announced its authorisation of a new (ECG) application that reportedly provides 95% accurate, instant results.Produced with ProCardio Medical Equipment Company, this new app can apparently be used to “accurately and quickly read, analyse, and diagnose the patient's condition, which would be particularly important in dealing with critical cases, such as cardiac arrhythmia.”EMR platform Docon Technologies by digital health company API Holdings has received government approval to integrate with the Ayush Bharat Health Account, the health ID component of the Ayush Bharat Digital Mission. Docon helps in digitising healthcare practices by enabling care provision via virtual clinics. It offers a patient health record management system that empowers better diagnosis. Through its type-free interface and learning algorithms, it is able to quickly generate a prescription. The company also does home delivery of medicines and diagnostics in partnership with digital pharmacies and diagnostics providers.WHY IT MATTERSThe digital clinic is among the country's first providers to adopt and enable the government's ABHA.

The health ID is a way for patients to create their digital health records and to access and share these data with their care providers and payers. It also allows them to receive digital lab reports, prescriptions, and diagnoses from verified medical professionals. The ABHA ultimately enables doctors and patients to seamlessly connect within the Indian digital health ecosystem."Just as UPI (Unified Payments Interface) and online payments changed the way consumers transact, health ID-enabled Docon will change the way doctors and patients interact, providing deep patient health history and understanding to the doctors, allowing them to deliver the best patient outcome," Akash Valia, head of Docon, said about their platform's integration with ABHA.THE LARGER CONTEXTIn August, the government launched the ABDM, which aims to build the digital infrastructure of India's healthcare system. This digital ecosystem consists of the following. Digital health ID, doctor registry, health facility registry, personal health record and electronic health record.

Early this month, the National Health Authority said it will proceed to develop the Unified Health Interface (UHI), an open network for interoperable digital health services. A core component of the ABDM, the UHI will adopt an open protocol to ensure interoperability..

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Research up to now shows small effects of these interventions, but purchase levitra canada even small effects may have a large impact because of the large number of people receiving these interventions. However, such small effects may also be related to the modest quality of the trials in this area. This means that current research has no clear indication whether universal prevention has a large public health impact or no impact at all.

The MYRIAD trial is a large, fully powered, high-quality study showing that universal prevention probably is not effective, although it it is possible that other interventions or approaches do have significant effects. We should seriously consider purchase levitra canada to move to other approaches to reduce the disease burden of depression in adolescents. Indirect approaches seem to be a feasible and promising alternative approach to prevention and increase the uptake of effective interventions.Depression &.

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AbstractUniversal school programmes aimed at the prevention of depression and other common mental health problems in adolescents are attractive because they are less stigmatising than targeted interventions, have a high uptake and may shift buy levitra in canada the ‘normal distribution’ of mental health problems in the positive direction. Research up to now shows small effects of these interventions, but even small effects may have a large impact because of the large number of people receiving these interventions. However, such small effects may also be related to the modest quality of the trials in this area.

This means that current research has no clear indication whether universal prevention has a large public health impact or no impact at all. The MYRIAD trial is a large, fully powered, high-quality study showing that universal prevention probably is not effective, although it it is possible buy levitra in canada that other interventions or approaches do have significant effects. We should seriously consider to move to other approaches to reduce the disease burden of depression in adolescents.

Indirect approaches seem to be a feasible and promising alternative approach to prevention and increase the uptake of effective interventions.Depression &. Mood disordersChild &.

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Summary Chart of MSP Programs with current income limits 2. Income Limits &. Rules and Household Size 3. The Three MSP Programs - What are they and how are they Different?.

4. FOUR Special Benefits of MSP Programs. Back Door to Extra Help with Part D MSPs Automatically Waive Late Enrollment Penalties for Part B - and allow enrollment in Part B year-round outside of the short Annual Enrollment Period No Medicaid Lien on Estate to Recover Payment of Expenses Paid by MSP Food Stamps/SNAP not reduced by Decreased Medical Expenses when Enroll in MSP - at least temporarily 5. Enrolling in an MSP - Automatic Enrollment &.

Applications for People who Have Medicare WHO IS AUTOMATICALLY ENROLLED IN AN MSP Applying for MSP Directly with Local Medicaid Program - including those who already have Medicaid through local Medicaid program but need MSP, and those newly applying for MSP Enrolling in an MSP if you have Medicaid and Just Became Eligible for Medicare MIPPA - SSA Notifies Social Security recipients that they may be eligible for MSP based on their income. 6. Enrolling in an MSP for People age 65+ who Do Not Qualify for Free Medicare Part A - the "Part A Buy-In Program" 7. What Happens After MSP Approved - How Part B Premium is Paid 8 Special Rules for QMBs - How Medicare Cost-Sharing Works 1.

NO ASSET LIMIT!. Since April 1, 2008, none of the three MSP programs have resource limits in New York -- which means many Medicare beneficiaries who might not qualify for Medicaid because of excess resources can qualify for an MSP. 1.A. SUMMARY CHART OF MSP BENEFITS QMB SLIMB QI-1 Eligibility ASSET LIMIT NO LIMIT IN NEW YORK STATE INCOME LIMIT (2022) Single Couple Single Couple Single Couple $1,133 $1,526 $1,359 $1,831 $1,529 $2,060 Federal Poverty Level 100% FPL 100 – 120% FPL 120 – 135% FPL Benefits Pays Monthly Part B premium?.

YES, and also Part A premium if did not have enough work quarters and meets citizenship requirement. See “Part A Buy-In” YES YES Pays Part A &. B deductibles &. Co-insurance YES - with limitations NO NO Retroactive to Filing of Application?.

Yes - Benefits begin the month after the month of the MSP application. 18 NYCRR §360-7.8(b)(5) Yes – Retroactive to 3rd month before month of application, if eligible in prior months Yes – may be retroactive to 3rd month before month of applica-tion, but only within the current calendar year. (No retro for January application). See GIS 07 MA 027.

Can Enroll in MSP and Medicaid at Same Time?. YES YES NO!. Must choose between QI-1 and Medicaid. Cannot have both, not even Medicaid with a spend-down.

2. INCOME LIMITS and RULES Each of the three MSP programs has different income eligibility requirements and provides different benefits. The income limits are tied to the Federal Poverty Level (FPL). The figures in the chart are based on a document issued by HRA in March 2022 (Box 7) based on the 2022 FPL.

See 2022 Fact Sheet on MSP in NYS by Medicare Rights Center ENGLISH SPANISH Income is determined by the same methodology as is used for determining in eligibility for SSI The rules for counting income for SSI-related (Aged 65+, Blind, or Disabled) Medicaid recipients, borrowed from the SSI program, apply to the MSP program, except for the new rules about counting household size for married couples. N.Y. Soc. Serv.

L. 367-a(3)(c)(2), NYS DOH 2000-ADM-7, 89-ADM-7 p.7. Gross income is counted, although there are certain types of income that are disregarded. The most common income disregards, also known as deductions, include.

(a) The first $20 of your &. Your spouse's monthly income, earned or unearned ($20 per couple max). (b) SSI EARNED INCOME DISREGARDS. * The first $65 of monthly wages of you and your spouse, * One-half of the remaining monthly wages (after the $65 is deducted).

* Other work incentives including PASS plans, impairment related work expenses (IRWEs), blind work expenses, etc. For information on these deductions, see The Medicaid Buy-In for Working People with Disabilities (MBI-WPD) and other guides in this article -- though written for the MBI-WPD, the work incentives apply to all Medicaid programs, including MSP, for people age 65+, disabled or blind. (c) monthly cost of any health insurance premiums but NOT the Part B premium, since Medicaid will now pay this premium (may deduct Medigap supplemental policies, vision, dental, or long term care insurance premiums, and the Part D premium but only to the extent the premium exceeds the Extra Help benchmark amount) (d) Food stamps not counted. You can get a more comprehensive listing of the SSI-related income disregards on the Medicaid income disregards chart.

As for all benefit programs based on financial need, it is usually advantageous to be considered a larger household, because the income limit is higher. The above chart shows that Households of TWO have a higher income limit than households of ONE. The MSP programs use the same rules as Medicaid does for the Disabled, Aged and Blind (DAB) which are borrowed from the SSI program for Medicaid recipients in the “SSI-related category.” Under these rules, a household can be only ONE or TWO. 18 NYCRR 360-4.2.

See DAB Household Size Chart. Married persons can sometimes be ONE or TWO depending on arcane rules, which can force a Medicare beneficiary to be limited to the income limit for ONE person even though his spouse who is under 65 and not disabled has no income, and is supported by the client applying for an MSP. EXAMPLE. Bob's Social Security is $1300/month.

He is age 67 and has Medicare. His wife, Nancy, is age 62 and is not disabled and does not work. Under the old rule, Bob was not eligible for an MSP because his income was above the Income limit for One, even though it was well under the Couple limit. In 2010, NYS DOH modified its rules so that all married individuals will be considered a household size of TWO.

DOH GIS 10 MA 10 Medicare Savings Program Household Size, June 4, 2010. This rule for household size is an exception to the rule applying SSI budgeting rules to the MSP program. Under these rules, Bob is now eligible for an MSP. When is One Better than Two?.

Of course, there may be couples where the non-applying spouse's income is too high, and disqualifies the applying spouse from an MSP. In such cases, "spousal refusal" may be used SSL 366.3(a). (Link is to NYC HRA form, can be adapted for other counties). In NYC, if you have a Medicaid case with HRA, instead of submitting an MSP application, you only need to complete and submit MAP-751W (check off "Medicare Savings Program Evaluation") and fax to (917) 639-0837.

(The MAP-751W is also posted in languages other than English in this link. (Updated 4/14/2021.)) 3. The Three Medicare Savings Programs - what are they and how are they different?. 1.

Qualified Medicare Beneficiary (QMB). The QMB program provides the most comprehensive benefits. Available to those with incomes at or below 100% of the Federal Poverty Level (FPL), the QMB program covers virtually all Medicare cost-sharing obligations. Part B premiums, Part A premiums, if there are any, and any and all deductibles and co-insurance.

QMB coverage is not retroactive. The program’s benefits will begin the month after the month in which your client is found eligible. ** See special rules about cost-sharing for QMBs below - updated with new CMS directive issued January 2012 ** See NYC HRA QMB Recertification form ** Even if you do not have Part A automatically, because you did not have enough wages, you may be able to enroll in the Part A Buy-In Program, in which people eligible for QMB who do not otherwise have Medicare Part A may enroll, with Medicaid paying the Part A premium (Materials by the Medicare Rights Center). 2.

Specifiedl Low-Income Medicare Beneficiary (SLMB). For those with incomes between 100% and 120% FPL, the SLMB program will cover Part B premiums only. SLMB is retroactive, however, providing coverage for three months prior to the month of application, as long as your client was eligible during those months. 3.

Qualified Individual (QI-1). For those with incomes between 120% and 135% FPL, and not receiving Medicaid, the QI-1 program will cover Medicare Part B premiums only. QI-1 is also retroactive, providing coverage for three months prior to the month of application, as long as your client was eligible during those months. However, QI-1 retroactive coverage can only be provided within the current calendar year.

(GIS 07 MA 027) So if you apply in January, you get no retroactive coverage. Q-I-1 recipients would be eligible for Medicaid with a spend-down, but if they want the Part B premium paid, they must choose between enrolling in QI-1 or Medicaid. They cannot be in both. It is their choice.

DOH MRG p. 19. In contrast, one may receive Medicaid and either QMB or SLIMB. 4.

Four Special Benefits of MSPs (in addition to NO ASSET TEST). Benefit 1. Back Door to Medicare Part D "Extra Help" or Low Income Subsidy -- All MSP recipients are automatically enrolled in Extra Help, the subsidy that makes Part D affordable. They have no Part D deductible or doughnut hole, the premium is subsidized, and they pay very low copayments.

Once they are enrolled in Extra Help by virtue of enrollment in an MSP, they retain Extra Help for the entire calendar year, even if they lose MSP eligibility during that year. The "Full" Extra Help subsidy has the same income limit as QI-1 - 135% FPL. However, many people may be eligible for QI-1 but not Extra Help because QI-1 and the other MSPs have no asset limit. People applying to the Social Security Administration for Extra Help might be rejected for this reason.

Recent (2009-10) changes to federal law called "MIPPA" requires the Social Security Administration (SSA) to share eligibility data with NYSDOH on all persons who apply for Extra Help/ the Low Income Subsidy. Data sent to NYSDOH from SSA will enable NYSDOH to open MSP cases on many clients. The effective date of the MSP application must be the same date as the Extra Help application. Signatures will not be required from clients.

In cases where the SSA data is incomplete, NYSDOH will forward what is collected to the local district for completion of an MSP application. The State implementing procedures are in DOH 2010 ADM-03. Also see CMS "Dear State Medicaid Director" letter dated Feb. 18, 2010 Benefit 2.

MSPs Automatically Waive Late Enrollment Penalties for Part B Generally one must enroll in Part B within the strict enrollment periods after turning age 65 or after 24 months of Social Security Disability. An exception is if you or your spouse are still working and insured under an employer sponsored group health plan, or if you have End Stage Renal Disease, and other factors, see this from Medicare Rights Center. If you fail to enroll within those short periods, you might have to pay higher Part B premiums for life as a Late Enrollment Penalty (LEP). Also, you may only enroll in Part B during the Annual Enrollment Period from January 1 - March 31st each year, with Part B not effective until the following July.

Enrollment in an MSP automatically eliminates such penalties... For life.. Even if one later ceases to be eligible for the MSP. AND enrolling in an MSP will automatically result in becoming enrolled in Part B if you didn't already have it and only had Part A.

See Medicare Rights Center flyer. Benefit 3. No Medicaid Lien on Estate to Recover MSP Benefits Paid Generally speaking, states may place liens on the Estates of deceased Medicaid recipients to recover the cost of Medicaid services that were provided after the recipient reached the age of 55. Since 2002, states have not been allowed to recover the cost of Medicare premiums paid under MSPs.

In 2010, Congress expanded protection for MSP benefits. Beginning on January 1, 2010, states may not place liens on the Estates of Medicaid recipients who died after January 1, 2010 to recover costs for co-insurance paid under the QMB MSP program for services rendered after January 1, 2010. The federal government made this change in order to eliminate barriers to enrollment in MSPs. See NYS DOH GIS 10-MA-008 - Medicare Savings Program Changes in Estate Recovery The GIS clarifies that a client who receives both QMB and full Medicaid is exempt from estate recovery for these Medicare cost-sharing expenses.

Benefit 4. SNAP (Food Stamp) benefits not reduced despite increased income from MSP - at least temporarily Many people receive both SNAP (Food Stamp) benefits and MSP. Income for purposes of SNAP/Food Stamps is reduced by a deduction for medical expenses, which includes payment of the Part B premium. Since approval for an MSP means that the client no longer pays for the Part B premium, his/her SNAP/Food Stamps income goes up, so their SNAP/Food Stamps go down.

Here are some protections. Do these individuals have to report to their SNAP worker that their out of pocket medical costs have decreased?. And will the household see a reduction in their SNAP benefits, since the decrease in medical expenses will increase their countable income?. The good news is that MSP households do NOT have to report the decrease in their medical expenses to the SNAP/Food Stamp office until their next SNAP/Food Stamp recertification.

Even if they do report the change, or the local district finds out because the same worker is handling both the MSP and SNAP case, there should be no reduction in the household’s benefit until the next recertification. New York’s SNAP policy per administrative directive 02 ADM-07 is to “freeze” the deduction for medical expenses between certification periods. Increases in medical expenses can be budgeted at the household’s request, but NYS never decreases a household’s medical expense deduction until the next recertification. Most elderly and disabled households have 24-month SNAP certification periods.

Eventually, though, the decrease in medical expenses will need to be reported when the household recertifies for SNAP, and the household should expect to see a decrease in their monthly SNAP benefit. It is really important to stress that the loss in SNAP benefits is NOT dollar for dollar. A $100 decrease in out of pocket medical expenses would translate roughly into a $30 drop in SNAP benefits. See more info on SNAP/Food Stamp benefits by the Empire Justice Center, and on the State OTDA website.

Some clients will be automatically enrolled in an MSP by the New York State Department of Health (NYSDOH) shortly after attaining eligibility for Medicare. Others need to apply. The 2010 "MIPPA" law introduced some improvements to increase MSP enrollment. See 3rd bullet below.

Also, some people who had Medicaid through the Affordable Care Act before they became eligible for Medicare have special procedures to have their Part B premium paid before they enroll in an MSP. See below. WHO IS AUTOMATICALLY ENROLLED IN AN MSP. Clients receiving even $1.00 of Supplemental Security Income should be automatically enrolled into a Medicare Savings Program (most often QMB) under New York State’s Medicare Savings Program Buy-in Agreement with the federal government once they become eligible for Medicare.

They should receive Medicare Parts A and B. Clients who are already eligible for Medicare when they apply for Medicaid should be automatically assessed for MSP eligibility when they apply for Medicaid. (NYS DOH 2000-ADM-7 and GIS 05 MA 033). Clients who apply to the Social Security Administration for Extra Help, but are rejected, should be contacted &.

Enrolled into an MSP by the Medicaid program directly under new MIPPA procedures that require data sharing. Strategy TIP. Since the Extra Help filing date will be assigned to the MSP application, it may help the client to apply online for Extra Help with the SSA, even knowing that this application will be rejected because of excess assets or other reason. SSA processes these requests quickly, and it will be routed to the State for MSP processing.

Since MSP applications take a while, at least the filing date will be retroactive. Note. The above strategy does not work as well for QMB, because the effective date of QMB is the month after the month of application. As a result, the retroactive effective date of Extra Help will be the month after the failed Extra Help application for those with QMB rather than SLMB/QI-1.

APPLYING FOR MSP DIRECTLY WITH LOCAL MEDICAID OFFICE Client already has Medicaid with Local District/HRA but not MSP. They should NOT have to submit an MSP application because the local district is required to review all Medicaid recipients for MSP eligibility and enroll them. (NYS DOH 2000-ADM-7 and GIS 05 MA 033). But if a Medicaid recipient does not have MSP, contact the Local Medicaid office and request that they be enrolled.

In NYC - Use Form 751W and check the box on page 2 requesting evaluation for Medicare Savings Program. Fax it to the Undercare Division at 1-917-639-0837 or email it to undercareproviderrelations@hra.nyc.gov. Use by secure email. If enrolling in the MSP will cause a Spenddown (because income will increase by the amount of the Part B premium, include a completed and signed "Choice Notice" (MAP-3054a)(3/19/2019)(You must adapt this notice - generally check box 3B on page 2 to select enrollment in MSP while keeping Medicaid.) If do not have Medicaid -- must apply for an MSP through their local social services district.

(See more in Section D. Below re those who already have Medicaid through the Affordable Care Act before they became eligible for Medicare. If you are applying for MSP only (not also Medicaid), you can use the simplified MSP application form (theDOH-4328(Rev. 8/2017-- English) (2017 Spanish version not yet available).

Either application form can be mailed in -- there is no interview requirement anymore for MSP or Medicaid. See 10 ADM-04. Applicants will need to submit proof of income, a copy of their Medicare card (front &. Back), and proof of residency/address.

See the application form for other instructions. One who is only eligible for QI-1 because of higher income may ONLY apply for an MSP, not for Medicaid too. One may not receive Medicaid and QI-1 at the same time. If someone only eligible for QI-1 wants Medicaid, s/he may enroll in and deposit excess income into a pooled Supplemental Needs Trust, to bring her countable income down to the Medicaid level, which also qualifies him or her for SLIMB or QMB instead of QI-1.

Advocates in NYC can sign up for a half-day "Deputization Training" conducted by the Medicare Rights Center, at which you'll be trained and authorized to complete an MSP application and to submit it via the Medicare Rights Center, which submits it to HRA without the client having to apply in person. Enrolling in an MSP if you already have Medicaid, but just become eligible for Medicare" The procedure for getting the Part B premium paid is different for those whose Medicaid was administered by the NYS of Health Exchange (Marketplace), as opposed to their local social services district. The procedure is also different for those who obtain Medicare because they turn 65, as opposed to obtaining Medicare based on disability. Either way, Medicaid recipients who transition onto Medicare should be automatically evaluated for MSP eligibility at their next Medicaid recertification.

NYS DOH 2000-ADM-7 Individuals can also affirmatively ask to be enrolled in MSP in between recertification periods. Individuals who are eligible for Medicaid with a spenddown can opt whether or not to receive MSP. (Medicaid Reference Guide (MRG) p. 19).

Obtaining MSP may increase their spenddown. IF CLIENT HAD MEDICAID ON THE MARKETPLACE (NYS of Health Exchange) before obtaining Medicare - See article about the Medicare Insurance Payment Program (MIPP). IF CLIENT HAD MEDICAID THROUGH LOCAL DISTRICT - see here, same procedure for any Medicaid recipient who needs MSP. MIPPA - Under MIPPA, the SSA sends a form letter to people who may be eligible for a Medicare Savings Program or Extra Help (Low Income Subsidy - LIS) that they may apply.

The letters are. · Beneficiary has Extra Help (LIS), but not MSP · Beneficiary has no Extra Help (LIS) or MSP 6. Enrolling in MSP for People Age 65+ who do Not have Free Medicare Part A - the "Part A Buy-In Program" Seniors WITHOUT MEDICARE PART A or B -- They may be able to enroll in the Part A Buy-In program, in which people eligible for QMB who are age 65+ who do not otherwise have Medicare Part A may enroll in Part A, with Medicaid paying the Part A premium. See Step-by-Step Guide by the Medicare Rights Center).

This guide explains the various steps in "conditionally enrolling" in Part A at the SSA office, which must be done before applying for QMB at the Medicaid office, which will then pay the Part A premium. See also GIS 04 MA/013. In June, 2018, the SSA revised the POMS manual procedures for the Part A Buy-In to to address inconsistencies and confusion in SSA field offices and help smooth the path for QMB enrollment. The procedures are in the POMS Section HI 00801.140 "Premium-Free Part A Enrollments for Qualified Medicare BenefiIaries." It includes important clarifications, such as.

SSA Field Offices should explain the QMB program and conditional enrollment process if an individual lacks premium-free Part A and appears to meet QMB requirements. SSA field offices can add notes to the “Remarks” section of the application and provide a screen shot to the individual so the individual can provide proof of conditional Part A enrollment when applying for QMB through the state Medicaid program. Beneficiaries are allowed to complete the conditional application even if they owe Medicare premiums. In Part A Buy-in states like NYS, SSA should process conditional applications on a rolling basis (without regard to enrollment periods), even if the application coincides with the General Enrollment Period.

(The General Enrollment Period is from Jan 1 to March 31st every year, in which anyone eligible may enroll in Medicare Part A or Part B to be effective on July 1st). 7. What happens after the MSP approval - How is Part B premium paid For all three MSP programs, the Medicaid program is now responsible for paying the Part B premiums, even though the MSP enrollee is not necessarily a recipient of Medicaid. The local Medicaid office (DSS/HRA) transmits the MSP approval to the NYS Department of Health – that information gets shared w/ SSA and CMS SSA stops deducting the Part B premiums out of the beneficiary’s Social Security check.

SSA also refunds any amounts owed to the recipient. (Note. This process can take awhile!. !.

!. ) CMS “deems” the MSP recipient eligible for Part D Extra Help/ Low Income Subsidy (LIS). ​Can the MSP be retroactive like Medicaid, back to 3 months before the application?. ​The answer is different for the 3 MSP programs.

find this This supplement collects information buy levitra in canada about the applicant's current resources and past resources (for nursing home coverage). All local districts in New York State are required to accept the revised DOH-4220 for non-MAGI Medicaid applicants (Aged 65+, Blind, Disabled) (including for coverage of long-term care services), Medicare Savings Program, the Medicaid Buy-In Program fr Working People with Disabilities. Districts must also continue to accept the LDSS-2921, although it only makes sense to use this when someone is applying for both Medicaid and some other public benefit covered by the Common Application, such as the income benefits such as Safety Net Assistance. The DOH-4220 - Access NY Health Care application can be used for all Medicaid benefits buy levitra in canada -- including for those who want to apply for coverage of Medicaid long-term care -- whether through home care or for those in a nursing home.j (with the addition of the Supplement A form, described below). DO NOT USE THE DOH-4220 FOR.

WHAT IF THE APPLICANT CANNOT SIGN THE APPLICATION?. DOH buy levitra in canada APPLICATION - WHERE TO FIND ONLINE Check here for updates and changes English Spanish This article was authored by the Evelyn Frank Legal Resources Program of New York Legal Assistance Group.March 2022 Alert -- Tell your State Senator and Assemblyperson and Gov. Hochul to expand income limits for MSPs - Support Senate Bill S8228/A9245 - see more here!. Medicare Savings Programs (MSPs) pay for the monthly Medicare Part B premium for low-income Medicare beneficiaries and qualify enrollees for the "Extra Help" subsidy for Part D prescription drugs. There are three separate MSP programs, the Qualified Medicare Beneficiary (QMB) Program, buy levitra in canada the Specified Low Income Medicare Beneficiary (SLMB) Program and the Qualified Individual (QI) Program, each of which is discussed below.

Those in QMB receive additional subsidies for Medicare costs. Download the 2022 Fact Sheet on MSP in NYS by Medicare Rights Center ENGLISH SPANISH State law. N.Y buy levitra in canada. Soc. Serv.

L. § 367-a(3)(a), (b), and (d). Note. Some consumers may be eligible for the Medicare Insurance Premium Payment (MIPP) Program, instead of MSP. See this article for more info.

TOPICS COVERED IN THIS ARTICLE 1. No Asset Limit 1A. Summary Chart of MSP Programs with current income limits 2. Income Limits &. Rules and Household Size 3.

The Three MSP Programs - What are they and how are they Different?. 4. FOUR Special Benefits of MSP Programs. Back Door to Extra Help with Part D MSPs Automatically Waive Late Enrollment Penalties for Part B - and allow enrollment in Part B year-round outside of the short Annual Enrollment Period No Medicaid Lien on Estate to Recover Payment of Expenses Paid by MSP Food Stamps/SNAP not reduced by Decreased Medical Expenses when Enroll in MSP - at least temporarily 5. Enrolling in an MSP - Automatic Enrollment &.

Applications for People who Have Medicare WHO IS AUTOMATICALLY ENROLLED IN AN MSP Applying for MSP Directly with Local Medicaid Program - including those who already have Medicaid through local Medicaid program but need MSP, and those newly applying for MSP Enrolling in an MSP if you have Medicaid and Just Became Eligible for Medicare MIPPA - SSA Notifies Social Security recipients that they may be eligible for MSP based on their income. 6. Enrolling in an MSP for People age 65+ who Do Not Qualify for Free Medicare Part A - the "Part A Buy-In Program" 7. What Happens After MSP Approved - How Part B Premium is Paid 8 Special Rules for QMBs - How Medicare Cost-Sharing Works 1. NO ASSET LIMIT!.

Since April 1, 2008, none of the three MSP programs have resource limits in New York -- which means many Medicare beneficiaries who might not qualify for Medicaid because of excess resources can qualify for an MSP. 1.A. SUMMARY CHART OF MSP BENEFITS QMB SLIMB QI-1 Eligibility ASSET LIMIT NO LIMIT IN NEW YORK STATE INCOME LIMIT (2022) Single Couple Single Couple Single Couple $1,133 $1,526 $1,359 $1,831 $1,529 $2,060 Federal Poverty Level 100% FPL 100 – 120% FPL 120 – 135% FPL Benefits Pays Monthly Part B premium?. YES, and also Part A premium if did not have enough work quarters and meets citizenship requirement. See “Part A Buy-In” YES YES Pays Part A &.

B deductibles &. Co-insurance YES - with limitations NO NO Retroactive to Filing of Application?. Yes - Benefits begin the month after the month of the MSP application. 18 NYCRR §360-7.8(b)(5) Yes – Retroactive to 3rd month before month of application, if eligible in prior months Yes – may be retroactive to 3rd month before month of applica-tion, but only within the current calendar year. (No retro for January application).

See GIS 07 MA 027. Can Enroll in MSP and Medicaid at Same Time?. YES YES NO!. Must choose between QI-1 and Medicaid. Cannot have both, not even Medicaid with a spend-down.

2. INCOME LIMITS and RULES Each of the three MSP programs has different income eligibility requirements and provides different benefits. The income limits are tied to the Federal Poverty Level (FPL). The figures in the chart are based on a document issued by HRA in March 2022 (Box 7) based on the 2022 FPL. See 2022 Fact Sheet on MSP in NYS by Medicare Rights Center ENGLISH SPANISH Income is determined by the same methodology as is used for determining in eligibility for SSI The rules for counting income for SSI-related (Aged 65+, Blind, or Disabled) Medicaid recipients, borrowed from the SSI program, apply to the MSP program, except for the new rules about counting household size for married couples.

N.Y. Soc. Serv. L. 367-a(3)(c)(2), NYS DOH 2000-ADM-7, 89-ADM-7 p.7.

Gross income is counted, although there are certain types of income that are disregarded. The most common income disregards, also known as deductions, include. (a) The first $20 of your &. Your spouse's monthly income, earned or unearned ($20 per couple max). (b) SSI EARNED INCOME DISREGARDS.

* The first $65 of monthly wages of you and your spouse, * One-half of the remaining monthly wages (after the $65 is deducted). * Other work incentives including PASS plans, impairment related work expenses (IRWEs), blind work expenses, etc. For information on these deductions, see The Medicaid Buy-In for Working People with Disabilities (MBI-WPD) and other guides in this article -- though written for the MBI-WPD, the work incentives apply to all Medicaid programs, including MSP, for people age 65+, disabled or blind. (c) monthly cost of any health insurance premiums but NOT the Part B premium, since Medicaid will now pay this premium (may deduct Medigap supplemental policies, vision, dental, or long term care insurance premiums, and the Part D premium but only to the extent the premium exceeds the Extra Help benchmark amount) (d) Food stamps not counted. You can get a more comprehensive listing of the SSI-related income disregards on the Medicaid income disregards chart.

As for all benefit programs based on financial need, it is usually advantageous to be considered a larger household, because the income limit is higher. The above chart shows that Households of TWO have a higher income limit than households of ONE. The MSP programs use the same rules as Medicaid does for the Disabled, Aged and Blind (DAB) which are borrowed from the SSI program for Medicaid recipients in the “SSI-related category.” Under these rules, a household can be only ONE or TWO. 18 NYCRR 360-4.2. See DAB Household Size Chart.

Married persons can sometimes be ONE or TWO depending on arcane rules, which can force a Medicare beneficiary to be limited to the income limit for ONE person even though his spouse who is under 65 and not disabled has no income, and is supported by the client applying for an MSP. EXAMPLE. Bob's Social Security is $1300/month. He is age 67 and has Medicare. His wife, Nancy, is age 62 and is not disabled and does not work.

Under the old rule, Bob was not eligible for an MSP because his income was above the Income limit for One, even though it was well under the Couple limit. In 2010, NYS DOH modified its rules so that all married individuals will be considered a household size of TWO. DOH GIS 10 MA 10 Medicare Savings Program Household Size, June 4, 2010. This rule for household size is an exception to the rule applying SSI budgeting rules to the MSP program. Under these rules, Bob is now eligible for an MSP.

When is One Better than Two?. Of course, there may be couples where the non-applying spouse's income is too high, and disqualifies the applying spouse from an MSP. In such cases, "spousal refusal" may be used SSL 366.3(a). (Link is to NYC HRA form, can be adapted for other counties). In NYC, if you have a Medicaid case with HRA, instead of submitting an MSP application, you only need to complete and submit MAP-751W (check off "Medicare Savings Program Evaluation") and fax to (917) 639-0837.

(The MAP-751W is also posted in languages other than English in this link. (Updated 4/14/2021.)) 3. The Three Medicare Savings Programs - what are they and how are they different?. 1. Qualified Medicare Beneficiary (QMB).

The QMB program provides the most comprehensive benefits. Available to those with incomes at or below 100% of the Federal Poverty Level (FPL), the QMB program covers virtually all Medicare cost-sharing obligations. Part B premiums, Part A premiums, if there are any, and any and all deductibles and co-insurance. QMB coverage is not retroactive. The program’s benefits will begin the month after the month in which your client is found eligible.

** See special rules about cost-sharing for QMBs below - updated with new CMS directive issued January 2012 ** See NYC HRA QMB Recertification form ** Even if you do not have Part A automatically, because you did not have enough wages, you may be able to enroll in the Part A Buy-In Program, in which people eligible for QMB who do not otherwise have Medicare Part A may enroll, with Medicaid paying the Part A premium (Materials by the Medicare Rights Center). 2. Specifiedl Low-Income Medicare Beneficiary (SLMB). For those with incomes between 100% and 120% FPL, the SLMB program will cover Part B premiums only. SLMB is retroactive, however, providing coverage for three months prior to the month of application, as long as your client was eligible during those months.

3. Qualified Individual (QI-1). For those with incomes between 120% and 135% FPL, and not receiving Medicaid, the QI-1 program will cover Medicare Part B premiums only. QI-1 is also retroactive, providing coverage for three months prior to the month of application, as long as your client was eligible during those months. However, QI-1 retroactive coverage can only be provided within the current calendar year.

(GIS 07 MA 027) So if you apply in January, you get no retroactive coverage. Q-I-1 recipients would be eligible for Medicaid with a spend-down, but if they want the Part B premium paid, they must choose between enrolling in QI-1 or Medicaid. They cannot be in both. It is their choice. DOH MRG p.

19. In contrast, one may receive Medicaid and either QMB or SLIMB. 4. Four Special Benefits of MSPs (in addition to NO ASSET TEST). Benefit 1.

Back Door to Medicare Part D "Extra Help" or Low Income Subsidy -- All MSP recipients are automatically enrolled in Extra Help, the subsidy that makes Part D affordable. They have no Part D deductible or doughnut hole, the premium is subsidized, and they pay very low copayments. Once they are enrolled in Extra Help by virtue of enrollment in an MSP, they retain Extra Help for the entire calendar year, even if they lose MSP eligibility during that year. The "Full" Extra Help subsidy has the same income limit as QI-1 - 135% FPL. However, many people may be eligible for QI-1 but not Extra Help because QI-1 and the other MSPs have no asset limit.

People applying to the Social Security Administration for Extra Help might be rejected for this reason. Recent (2009-10) changes to federal law called "MIPPA" requires the Social Security Administration (SSA) to share eligibility data with NYSDOH on all persons who apply for Extra Help/ the Low Income Subsidy. Data sent to NYSDOH from SSA will enable NYSDOH to open MSP cases on many clients. The effective date of the MSP application must be the same date as the Extra Help application. Signatures will not be required from clients.

In cases where the SSA data is incomplete, NYSDOH will forward what is collected to the local district for completion of an MSP application. The State implementing procedures are in DOH 2010 ADM-03. Also see CMS "Dear State Medicaid Director" letter dated Feb. 18, 2010 Benefit 2. MSPs Automatically Waive Late Enrollment Penalties for Part B Generally one must enroll in Part B within the strict enrollment periods after turning age 65 or after 24 months of Social Security Disability.

An exception is if you or your spouse are still working and insured under an employer sponsored group health plan, or if you have End Stage Renal Disease, and other factors, see this from Medicare Rights Center. If you fail to enroll within those short periods, you might have to pay higher Part B premiums for life as a Late Enrollment Penalty (LEP). Also, you may only enroll in Part B during the Annual Enrollment Period from January 1 - March 31st each year, with Part B not effective until the following July. Enrollment in an MSP automatically eliminates such penalties... For life..

Even if one later ceases to be eligible for the MSP. AND enrolling in an MSP will automatically result in becoming enrolled in Part B if you didn't already have it and only had Part A. See Medicare Rights Center flyer. Benefit 3. No Medicaid Lien on Estate to Recover MSP Benefits Paid Generally speaking, states may place liens on the Estates of deceased Medicaid recipients to recover the cost of Medicaid services that were provided after the recipient reached the age of 55.

Since 2002, states have not been allowed to recover the cost of Medicare premiums paid under MSPs. In 2010, Congress expanded protection for MSP benefits. Beginning on January 1, 2010, states may not place liens on the Estates of Medicaid recipients who died after January 1, 2010 to recover costs for co-insurance paid under the QMB MSP program for services rendered after January 1, 2010. The federal government made this change in order to eliminate barriers to enrollment in MSPs. See NYS DOH GIS 10-MA-008 - Medicare Savings Program Changes in Estate Recovery The GIS clarifies that a client who receives both QMB and full Medicaid is exempt from estate recovery for these Medicare cost-sharing expenses.

Benefit 4. SNAP (Food Stamp) benefits not reduced despite increased income from MSP - at least temporarily Many people receive both SNAP (Food Stamp) benefits and MSP. Income for purposes of SNAP/Food Stamps is reduced by a deduction for medical expenses, which includes payment of the Part B premium. Since approval for an MSP means that the client no longer pays for the Part B premium, his/her SNAP/Food Stamps income goes up, so their SNAP/Food Stamps go down. Here are some protections.

Do these individuals have to report to their SNAP worker that their out of pocket medical costs have decreased?. And will the household see a reduction in their SNAP benefits, since the decrease in medical expenses will increase their countable income?. The good news is that MSP households do NOT have to report the decrease in their medical expenses to the SNAP/Food Stamp office until their next SNAP/Food Stamp recertification. Even if they do report the change, or the local district finds out because the same worker is handling both the MSP and SNAP case, there should be no reduction in the household’s benefit until the next recertification. New York’s SNAP policy per administrative directive 02 ADM-07 is to “freeze” the deduction for medical expenses between certification periods.

Increases in medical expenses can be budgeted at the household’s request, but NYS never decreases a household’s medical expense deduction until the next recertification. Most elderly and disabled households have 24-month SNAP certification periods. Eventually, though, the decrease in medical expenses will need to be reported when the household recertifies for SNAP, and the household should expect to see a decrease in their monthly SNAP benefit. It is really important to stress that the loss in SNAP benefits is NOT dollar for dollar. A $100 decrease in out of pocket medical expenses would translate roughly into a $30 drop in SNAP benefits.

See more info on SNAP/Food Stamp benefits by the Empire Justice Center, and on the State OTDA website. Some clients will be automatically enrolled in an MSP by the New York State Department of Health (NYSDOH) shortly after attaining eligibility for Medicare. Others need to apply. The 2010 "MIPPA" law introduced some improvements to increase MSP enrollment. See 3rd bullet below.

Also, some people who had Medicaid through the Affordable Care Act before they became eligible for Medicare have special procedures to have their Part B premium paid before they enroll in an MSP. See below. WHO IS AUTOMATICALLY ENROLLED IN AN MSP. Clients receiving even $1.00 of Supplemental Security Income should be automatically enrolled into a Medicare Savings Program (most often QMB) under New York State’s Medicare Savings Program Buy-in Agreement with the federal government once they become eligible for Medicare. They should receive Medicare Parts A and B.

Clients who are already eligible for Medicare when they apply for Medicaid should be automatically assessed for MSP eligibility when they apply for Medicaid. (NYS DOH 2000-ADM-7 and GIS 05 MA 033). Clients who apply to the Social Security Administration for Extra Help, but are rejected, should be contacted &. Enrolled into an MSP by the Medicaid program directly under new MIPPA procedures that require data sharing. Strategy TIP.

Since the Extra Help filing date will be assigned to the MSP application, it may help the client to apply online for Extra Help with the SSA, even knowing that this application will be rejected because of excess assets or other reason. SSA processes these requests quickly, and it will be routed to the State for MSP processing. Since MSP applications take a while, at least the filing date will be retroactive. Note. The above strategy does not work as well for QMB, because the effective date of QMB is the month after the month of application.

As a result, the retroactive effective date of Extra Help will be the month after the failed Extra Help application for those with QMB rather than SLMB/QI-1. APPLYING FOR MSP DIRECTLY WITH LOCAL MEDICAID OFFICE Client already has Medicaid with Local District/HRA but not MSP. They should NOT have to submit an MSP application because the local district is required to review all Medicaid recipients for MSP eligibility and enroll them. (NYS DOH 2000-ADM-7 and GIS 05 MA 033). But if a Medicaid recipient does not have MSP, contact the Local Medicaid office and request that they be enrolled.

In NYC - Use Form 751W and check the box on page 2 requesting evaluation for Medicare Savings Program. Fax it to the Undercare Division at 1-917-639-0837 or email it to undercareproviderrelations@hra.nyc.gov. Use by secure email. If enrolling in the MSP will cause a Spenddown (because income will increase by the amount of the Part B premium, include a completed and signed "Choice Notice" (MAP-3054a)(3/19/2019)(You must adapt this notice - generally check box 3B on page 2 to select enrollment in MSP while keeping Medicaid.) If do not have Medicaid -- must apply for an MSP through their local social services district. (See more in Section D.

Below re those who already have Medicaid through the Affordable Care Act before they became eligible for Medicare. If you are applying for MSP only (not also Medicaid), you can use the simplified MSP application form (theDOH-4328(Rev. 8/2017-- English) (2017 Spanish version not yet available). Either application form can be mailed in -- there is no interview requirement anymore for MSP or Medicaid. See 10 ADM-04.

Applicants will need to submit proof of income, a copy of their Medicare card (front &. Back), and proof of residency/address. See the application form for other instructions. One who is only eligible for QI-1 because of higher income may ONLY apply for an MSP, not for Medicaid too. One may not receive Medicaid and QI-1 at the same time.

If someone only eligible for QI-1 wants Medicaid, s/he may enroll in and deposit excess income into a pooled Supplemental Needs Trust, to bring her countable income down to the Medicaid level, which also qualifies him or her for SLIMB or QMB instead of QI-1. Advocates in NYC can sign up for a half-day "Deputization Training" conducted by the Medicare Rights Center, at which you'll be trained and authorized to complete an MSP application and to submit it via the Medicare Rights Center, which submits it to HRA without the client having to apply in person. Enrolling in an MSP if you already have Medicaid, but just become eligible for Medicare" The procedure for getting the Part B premium paid is different for those whose Medicaid was administered by the NYS of Health Exchange (Marketplace), as opposed to their local social services district. The procedure is also different for those who obtain Medicare because they turn 65, as opposed to obtaining Medicare based on disability. Either way, Medicaid recipients who transition onto Medicare should be automatically evaluated for MSP eligibility at their next Medicaid recertification.

NYS DOH 2000-ADM-7 Individuals can also affirmatively ask to be enrolled in MSP in between recertification periods. Individuals who are eligible for Medicaid with a spenddown can opt whether or not to receive MSP. (Medicaid Reference Guide (MRG) p. 19). Obtaining MSP may increase their spenddown.

IF CLIENT HAD MEDICAID ON THE MARKETPLACE (NYS of Health Exchange) before obtaining Medicare - See article about the Medicare Insurance Payment Program (MIPP). IF CLIENT HAD MEDICAID THROUGH LOCAL DISTRICT - see here, same procedure for any Medicaid recipient who needs MSP. MIPPA - Under MIPPA, the SSA sends a form letter to people who may be eligible for a Medicare Savings Program or Extra Help (Low Income Subsidy - LIS) that they may apply. The letters are. · Beneficiary has Extra Help (LIS), but not MSP · Beneficiary has no Extra Help (LIS) or MSP 6.

Enrolling in MSP for People Age 65+ who do Not have Free Medicare Part A - the "Part A Buy-In Program" Seniors WITHOUT MEDICARE PART A or B -- They may be able to enroll in the Part A Buy-In program, in which people eligible for QMB who are age 65+ who do not otherwise have Medicare Part A may enroll in Part A, with Medicaid paying the Part A premium. See Step-by-Step Guide by the Medicare Rights Center). This guide explains the various steps in "conditionally enrolling" in Part A at the SSA office, which must be done before applying for QMB at the Medicaid office, which will then pay the Part A premium. See also GIS 04 MA/013. In June, 2018, the SSA revised the POMS manual procedures for the Part A Buy-In to to address inconsistencies and confusion in SSA field offices and help smooth the path for QMB enrollment.

The procedures are in the POMS Section HI 00801.140 "Premium-Free Part A Enrollments for Qualified Medicare BenefiIaries." It includes important clarifications, such as. SSA Field Offices should explain the QMB program and conditional enrollment process if an individual lacks premium-free Part A and appears to meet QMB requirements. SSA field offices can add notes to the “Remarks” section of the application and provide a screen shot to the individual so the individual can provide proof of conditional Part A enrollment when applying for QMB through the state Medicaid program. Beneficiaries are allowed to complete the conditional application even if they owe Medicare premiums. In Part A Buy-in states like NYS, SSA should process conditional applications on a rolling basis (without regard to enrollment periods), even if the application coincides with the General Enrollment Period.

(The General Enrollment Period is from Jan 1 to March 31st every year, in which anyone eligible may enroll in Medicare Part A or Part B to be effective on July 1st). 7. What happens after the MSP approval - How is Part B premium paid For all three MSP programs, the Medicaid program is now responsible for paying the Part B premiums, even though the MSP enrollee is not necessarily a recipient of Medicaid. The local Medicaid office (DSS/HRA) transmits the MSP approval to the NYS Department of Health – that information gets shared w/ SSA and CMS SSA stops deducting the Part B premiums out of the beneficiary’s Social Security check. SSA also refunds any amounts owed to the recipient.

(Note. This process can take awhile!. !. !. ) CMS “deems” the MSP recipient eligible for Part D Extra Help/ Low Income Subsidy (LIS).

​Can the MSP be retroactive like Medicaid, back to 3 months before the application?. ​The answer is different for the 3 MSP programs. QMB -No Retroactive Eligibility – Benefits begin the month after the month of the MSP application. 18 NYCRR § 360-7.8(b)(5) SLIMB - YES - Retroactive Eligibility up to 3 months before the application, if was eligible This means applicant may be reimbursed for the 3 months of Part B benefits prior to the month of application.

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