The American people are hurting. As a result of the greed, recklessness and illegal behavior on Wall Street, millions of Americans have lost their jobs, homes, life savings and their ability to get a higher education. Today, some 22 percent of our children live in poverty, and millions more have become dependent on food stamps for their food.

Fiscal Year 2010-11 State Budget Reimbursement Contingency: Since the State of California did not enact the fiscal year 2010-11 budget by June 30, 2010, the Department of Health Care Services (DHCS) will direct the fiscal intermediary, HP Enterprise Services, to implement provisions pursuant to state law, to continue processing and adjudicating claims as outlined below.

Last week, the U.S. House of Representatives approved the Improper Payments Elimination and Recovery Act with my strong support, and the measure has now been signed into law. The legislation is designed to identify and eliminate improper payments from federal agency spending and recover the lost funds that agencies have misspent.

Associate Professor Emeritus of Psychiatry and Pediatrics (OHSU, Portland, Oregon) is seeking roughly 50-100 volunteer families to participate in a vitamin D study. The goal of the study is to find out whether giving Vitamin D to the pregnant mother, who already has had at least one previous child with autism, can prevent the recurrence of autism in the newborn sibling…

As with all major social legislation, years of decisions and disputes over implementation lie ahead for the Patient Protection and Affordable Care Act. Opponents at the state and national levels may seek the law’s judicial overturn or repeal. However, a far more serious effort to undermine the law will come about through challenges to various administrative arrangements, taxes, and subsidies to fund expansions of coverage.

The redistributive aspects of health reform will be especially at risk, as business interests and groups of more-privileged citizens press for lower taxes, looser regulations, and reduced subsidies for low-income people.

If you have a PPO or Indemnity Plan: Since these are plans where you can go outside of network or choose your own dentist the insurance company is out of the lope. Even though a dentist may call on coverages, it is up to you to make sure you are covered. You can do this by submitting a quote only to the claims department before the work is started or you can call. Many PPOs or Indemnity Plans pay based on % up to ACV/UCR so even though you may have coverage if your dentist is above the ACV/UCR you can get hit by a big bill. (that is why I advise to submit claims as quotes before the work is started. This helps you know what is your true cost for any procedure)

If you have an HMO: HMOs are different in that you have to go with their providers. Cost for procedures are normally fee based. Meaning that the dentist will charge based on the fees laid out to them under the plan. Therefore if you feel your dentist lied to you about your coverage I would start by calling the insurance company. Telling them what you had done (need ADA codes) and finding out your true cost. If they did a procedure that was not covered and told you it was then at least the insurance company will then be aware of this. They do not want their dentist doing such stuff to their Insured and to many complaints will have them removed from the program.

There is as you menshion the better business, but there is also the America Dentist Asso. ADA. Most states have there own ADA web site.

You can also find web sites that you can leave a blogs about the dentist you went to this will help others in not going to them. I sell dental insurance and dental plans so I have clients that tell me they google,yahoo, bing ect the dental office before choosing a dentist. I am just not sure how much effort you want to put into this.

Source: http://www.insurancecompany.com

Social Security, today announced that the agency has released its Open Government plan.  The plan, available at www.socialsecurity.gov/open, reflects the agency’s commitment to increase transparency, expand opportunities for citizen participation and collaboration, and make open government sustainable at Social Security.  Three flagship initiatives are highlighted in the plan — the Spanish-Language Retirement Estimator, Online Service Enhancement, and an Online Life-Expectancy Calculator.  These initiatives support the agency’s mission, goals, and objectives, as well as showcase the value of open government principles.

“I applaud President Obama’s commitment to opening the federal government to the people it serves and I am especially proud of the three flagship initiatives we have chosen to implement by the end of this year,” said Commissioner Astrue. “These initiatives signify Social Security’s ongoing commitment to transparency, citizen participation, and collaboration as we improve the services we provide to the public.”

Social Security’s Spanish-language Retirement Estimator will be the agency’s and the federal government’s first-ever non-English interactive Internet application — a tool that furthers transparency by offering the Spanish-speaking public an opportunity to get instant, personalized estimates of future retirement benefits.  Last year, over three million people used the English-language version of this popular online service available at www.socialsecurity.gov/estimator.

As part of its Online Service Enhancement initiative, Social Security will unveil a new service-channeling tool that will help people more easily find the information and services they seek on the agency’s website www.socialsecurity.gov.  A key feature will be the opportunity to go online to schedule an in-office appointment for those who are unable to use our online services to conduct all of their business.  This idea was submitted by Christie Dickson, an employee of Social Security, and was one of the finalists for the President’s SAVE award.  In developing this tool, the agency will collaborate with members of the public as well as with industry experts.

The agency also is developing an Online Life-Expectancy Calculator — a simple, but important tool to assist the public with retirement planning.  Many people substantially underestimate life expectancy, and this new online service will add a measure of accuracy to retirement planning by providing average life expectancies at different ages based on the person’s gender and date of birth, and drawing on assumptions provided in the annual Social Security Trustees’ report.

“I look forward to continuing to translate the values of open government into lasting improvements in the way the agency makes decisions, solves problems, and addresses its challenges,” said Commissioner Astrue.  “Social Security’s flagship initiatives will improve our services and further break down barriers between the American people and their government.”

Social Security encourages feedback on its Open Government plan.  To view the plan and share your comments and ideas, please visit www.socialsecurity.gov/open.

The Los Angeles Times’ Blog: “Gov. Arnold Schwarzenegger moved Wednesday to implement a major element of the new national healthcare overhaul, seeking a $1-million federal grant to strengthen the state’s review of health insurance rates. Much of the money would pay for actuaries to evaluate premium hikes sought by insurers. …

According to the National Association of Dental Plans, approximately half of the U.S. population does not have an affordable dental plan. The cost for affordable dental insurance can vary. Therefore, it is important to understand all your options in obtaining the most affordable dental plan coverage.

The company where you work may provide the most affordable dental insurance plan options. Dental insurance plans for individual and families are usually an HMO (Health Maintenance Organization) or a PPO (Preferred Provided Organization) and operate much like traditional health insurance organizations.

Affordable Dental Plans – HMO

Affordable dental insurance plans from an HMO have a limited pool of dentist to select, but it is a more affordable insurance plan. If you are self employed and looking for a more affordable dental plan, a discount dental plan may be an alternative.

Discount dental plans are not dental insurance plans. A discount plan partners with dentists to provide customers with a savings on visits to the dentist office. The downside to discount dental plans is that they are not regulated and you have limited recourse if you experience dental plan problems.

Affordable Dental Plans – Where to Buy

You can obtain quotes for more affordable dental insurance plans from companies online and through your local insurance agent or broker. Please keep in mind that there are many web sites who give the appearance of selling dental insurance but instead only offer a dental discount plan which is not insurance.

Your dentist may also have affordable dental plan options available to patients.  Ask the receptionist if they partner with a dental plan company and see if one might be right for you.

Affordable Dental Plans – Other Alternatives

If you belong to a professional association, you might be eligible for a dental insurance or discount dental plan. Many associations partner with a PPO to provide their members with dental plans that offer very comprehensive insurance coverage at more affordable prices.

Finally, dental schools may offer affordable dental services. Dental schools seem to be safe, but can be inconvenient and treatment for one problem may have to be addressed in multiple office visits.

The Patient Protection and Affordable Care Act establishes a national voluntary program for accountable care organizations (ACOs) by January 2012 under the auspices of the Centers for Medicare and Medicaid Services (CMS). The act also creates a Center for Medicare and Medicaid Innovation in the CMS. We propose that the CMS allow flexibility and tiers in ACOs based on their specific circumstances, such as the degree to which they are or are not fully integrated systems.

Further, we propose that the CMS assume responsibility for ACO provisions and develop an ordered system for learning how to create and sustain ACOs. Key steps would include setting specific performance goals, developing skills and tools that facilitate change, establishing measurement and accountability mechanisms, and supporting leadership development.

Commissioner of Social Security, today announced that the agency is submitting legislation to Congress that would prohibit states, without the Commissioner’s prior authorization, from reducing the number of state personnel who make disability determinations for Social Security or the hours they work below the amount the agency authorizes.

“It is long past time that states end these unconscionable furloughs and hiring freezes that needlessly harm citizens with disabilities,” Commissioner Astrue said.  “States realize no fiscal savings whatsoever from these actions and this legislation would prevent needless delays in the disability determination process.  I am grateful for the President’s support and urge Congress to move quickly to help us make this provision the law of the land.”

More than a dozen states have implemented furloughs and hiring freezes that affect the federally paid state workers who make disability determinations for Social Security.  The state agencies that employ these workers in their disability determination service (DDS) components receive 100 percent of their funding from the Federal government. Accordingly, states do not save any money by imposing furloughs and hiring freezes on federally funded employees.  Rather, they slow benefits to some of the most vulnerable citizens – for example, furloughs in California in fiscal year 2010 delayed payment of over $11 million in benefits to more than 40,000 citizens with disabilities.  State-imposed furloughs and hiring freezes also reduce state income tax revenue and increase unemployment in the state.

“The members of Local 1000 have always believed that furloughing federally funded positions doesn’t make economic sense and that has been proven in California during these past 18 months that Governor Schwarzenegger has imposed furloughs on state employees,” Yvonne Walker, President of Service Employees International Union Local 1000 said.   “I applaud Social Security for initiating legislation that would prevent further bad economic policy from going forward.  This provision will not only help DDS workers, but the claimants who rely on the services our members provide.”

“We commend the Commissioner for his forceful and dedicated leadership in taking this bold action,” said Susan X. Smith, President of the National Association of Disability Examiners (NADE).  “Our members are witness to the impact the current economic recession has had for disabled citizens and we are working hard to meet the dramatic increase in claims for benefits.  These furloughs further compound the problems faced by disabled citizens by creating unnecessary delays in the processing of their claims.  NADE urges quick action with regards to this legislative proposal.”

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