Centers for Medicare and Medicaid Services

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The Obama administration improperly paid insurance companies and HMOs nearly $434 million in 2014 when Affordable Care Act policies first became available, according to a new federal inspector general’s report. 

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Object to abortion? You may be able to get an exemption from the Affordable Care Act tax penalty for people who don't get health insurance.

Elderly Book End-Of-Life Talks Once Labeled 'Death Panels'

May 23, 2016

The doctor got right down to business after Herbert Diamond bounded in. A single green form before her, she had some questions for the agile 88-year-old: about comas and ventilators, about feeding tubes and CPR, about intense and irreversible suffering.

What Feds' Push To Share Health Data Means For Patients

May 9, 2016

Two years ago, when the federal government first released data on how much Medicare paid physicians, the media coverage was widespread. Doctors who earned significant sums were dubbed "Medicare millionaires" and journalists highlighted unusual patterns in how some doctors bill for services.

Florida Attorney General Pam Bondi says she was wrong to urge the U.S. Centers for Medicare & Medicaid Services to pay for high-priced and unnecessary drug screening tests from a company being investigated for defrauding Florida Medicaid of millions.

Associated Press

With time running out on open enrollment season, many seniors are facing sharply higher premiums for Medicare's popular prescription drug program. The reason: rising drug costs have overtaken a long stretch of stable premiums.

Senior citizens are switching from privately run insurance plans to traditional Medicare when they face serious, long-term health conditions, a study shows.

Researchers at Brown University found that 17 percent of Medicare Advantage patients who entered nursing homes for long-term care chose to switch to traditional Medicare the following year. Only 3 percent of similar patients in Medicare made the decision to go to a private Medicare Advantage plan.

Agency for Health Care Administration

 Justin Senior, Medicaid director for Florida's Agency for Health Care Administration, says the state still is in negotiations with the Centers for Medicare and Medicaid Services, though the agency announced it will not renew its Low Income Pool funding, the Miami Herald reports. 

Med-Care Diabetic and Medical Supplies

 The Federal Bureau of Investigation raided a Boca Raton medical-supply company early Wednesday, the South Florida Sun Sentinel reports. 

The company, Med-Care Diabetes and Medical Supplies, Inc., was the subject of a 2013 U.S. Senate subcommittee hearing for possible Medicare fraud and has ties to Daniel Porush, a man who helped inspire a character depicted in the movie “The Wolf of Wall Street”.

Many Florida shoppers at Medicare.gov will find Day Break and Sunrise among their lowest-priced HMO options. But if they call to enroll in either one, they’re out of luck.

Florida Healthcare Plus, a small Coral Gables company that sponsors the two Medicare Advantage plans, is under state and federal suspension, unable to sign up new members during the current open-enrollment season for Medicare, Oct. 15-Dec. 7. Being frozen at this time of year can be a death sentence for such plans.

Former Orlando Health patients may have to help repay the Centers for Medicare and Medicaid Services after a federal audit discovered the hospital overbilled Medicare by $1.45 million, the Orlando Sentinel reports.

Hospitals to Pay for Patient Harm

Jun 24, 2014

Beginning in October, hospitals that have higher-than-acceptable rates of patient complications will see their Medicare payments cut by 1 percent.  In Florida, 31 are in the danger zone, according to a preliminary analysis. 

Of those, two from the lower Gulf Coast were considered at extreme risk of penalty because their scores were so bad, according to the study by the Centers for Medicare and Medicaid Services.

FL Doctors Win Medicare Bonuses

Jun 12, 2014
Kaiser Health News

Hundreds of Florida doctors are recipients of the first round of bonuses from the federal government – a thank-you for saving taxpayers $33 million on Medicare last year.

Those who receive the performance bonuses are part of primary-care networks called “accountable care organizations,” or ACOs, created by the Affordable Care Act.  ACOs take financial responsibility for the care of their Medicare patients.  

Medicare Won't Pursue Overpayments

Jun 2, 2014

Medicare spent $6.7 billion too much for office visits and other patient evaluations in 2010, according to a new report from the inspector general of the U.S. Department of Health and Human Services.

But in its reply to the findings, the Centers for Medicare and Medicaid Services (CMS), which runs Medicare, said it doesn't plan to review the billings of doctors who almost always charge for the most expensive visits because it isn't cost effective to do so.

Changes in the funding formula for Medicaid that will take many millions of dollars away from large safety-net hospitals such as Jackson Memorial and Tampa General are getting lawmakers' attention, now that it's clear the federal government isn't going to pull the state's fat out of the fire.

Federal officials have imposed a fine on Florida Healthcare Plus, a Medicare Advantage plan based in Coral Gables, for failing to notify members of upcoming changes in the plan by the deadline last fall, just before  open-enrollment season.

Meanwhile, the plan seems to have retrenched, with some of its offices closing around the state. Calls to Florida Healthcare Plus offices in Orlando, Jacksonville and West Palm Beach drew recorded messages that said those numbers were no longer in service.

While one Florida hospital has been approved for adult heart transplants, another is temporarily closing its lung-transplant program.

U.S. Sen. Bill Nelson cranked up the hopes of many Democrats last week by hinting that he had a plan that might revive the moribund Medicaid expansion in Florida, which would cover those too poor to qualify for tax credits on Healthcare.gov.

The federal government intends to fine Florida for what it describes as a violation of the Social Security Act -- limiting Medicaid patients' emergency room visits to six a year -- the Tampa Bay Times reports.  

In December 2012, the Centers for Medicare and Medicaid Services  rejected the plan from the Florida Agency for Health Care Administration to cap the visits.

Twelve Florida hospitals had outcomes significantly better than average on results for hip and knee replacement operations in the past three years, according to Medicare data published on the Hospital Compare website.

Three of them scored significantly better than average on both the rates of complications and re-admissions, the two categories analyzed. They are Heart of Florida Regional Medical Center in Davenport, Holy Cross Hospital in Fort Lauderdale and Ocala Regional Medical Center.

What's Best Value in Medicare Plan?

Dec 3, 2013

Even when a Medicare Advantage plan wins the federal top-quality 5-star rating, it isn’t necessarily the right choice for every beneficiary, according to a cost-sharing analysis from HealthMetrix Research.

Lottie Watts/WUSF / WUSF

More than half of the Medicare Advantage plans available for enrollment now in Florida for 2014 coverage earned a rating of at least four stars out of five, according to data organized by Avalere Health

Four Florida plans -- all sponsored by Cigna -- earned the coveted five-star rating: three plans in Bay County and one in Miami-Dade. There were no five-star Advantage plans available in 2013 anywhere in Florida.

Florida's nursing-home inspectors have been ordered to curtail all work except complaints about life-and-death dangers because of the federal government's shutdown. Other health-care facilities and programs may be affected, as well.

State inspections and certification of health-care institutions and programs comprise one of the less-well-known pockets of federal spending affected by Congress' halt in funds for most government operations as of the beginning of fiscal year 2014 on Oct. 1.

Even as the state fends off two federal lawsuits over its practice of placing disabled children in nursing homes, the facilities themselves are backing away from the profitable but controversial business. 

As the Miami Herald reports, Orlando Health & Rehabilitation is closing “Grandma’s House,” its 40-bed pediatric wing.

According to an investigation by ProPublica and The Washington Post, Medicare is failing to properly monitor the drugs prescribed under Part D coverage. Analysis of the data shows doctors are overprescribing, and in some cases, giving seniors drugs that are potentially harmful or addictive. 

Nearly half of Universal Health Care customers -- those enrolled in a Medicare plan --  need to act immediately if they want to protect themselves from the possibility of unexpected expenses next month.

If they switch plans by Sunday, March 31, they will be fully covered under their new plan as of Monday, April 1. If they don't, the federal government will automatically enroll them in traditional Medicare. If they had prescription-drug coverage under Universal, they will be automatically enrolled in a drug plan.

Tampa Tribune

Florida's Republican legislative leaders say they believe they can get full federal funding for Medicaid expansion under the Affordable Care Act, even though they propose to use it to buy subsidized private health insurance.

If they are wrong, they will be giving up a huge windfall of federal funding, which state economists last week estimated at $51 billion over the next decade. But if they are correct, they will have accomplished quite a political feat: