Medicare

Seven hospitals in Florida have agreed to pay the federal government about $9 million to settle allegations they submitted false claims to Medicare for a minimally-invasive procedure commonly used to treat spinal fractures from osteoporosis, a news release from the U.S. Department of Justice says.

A Fort Myers-based integrated cancer care services provider accused of billing for tests that were not needed will pay nearly $20 million to the federal government to settle allegations from a whistleblower that it violated the False Claims Act, according to a news release from the U.S. Department of Justice.

Medicare Penalizes 29 Florida Hospitals For Safety Incidents

Dec 15, 2015

The federal government is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those places had also been fined last year, Medicare records released late Wednesday show.

A national healthcare company showed off its first Florida clinic today and it’s right here in Jacksonville. 

Alignment Healthcare is partnering with St. Vincent’s HealthCare and Florida Blue to provide comprehensive care to Medicare patients in Clay and Duval Counties.

Alignment Healthcare’s Chief Medical Officer Doctor Henry Do says one way they do that is with what’s called population care.

In recent months, hospital systems in Florida have paid out hundreds of millions of dollars to settle allegations of illegally compensating physicians. According to Modern Healthcare, those huge settlements are catching the attention of other potential whistleblowers.

End Of Medicare Bonuses Will Cut Pay To Primary Care Doctors

Nov 30, 2015

Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients.

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.

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.

U.S. Army

Striving for better quality and more predictable costs, Medicare on Monday launched a major payment change for hip and knee replacements, the most common inpatient surgery for its 55 million beneficiaries.

.S. Department of Health and Human Services

One month into Medicare's enrollment period for seniors, the federal government announced that Medicare Part B premiums will be going up in 2016 for new enrollees.

Not every American 65 and older is worrying about Medicare's open enrollment period, now underway. Some who are eligible for the government insurance plan are staying on the job, and gaining access to employer-based plans they say are a better option. 

WellCare Sees Increase In Earnings

Nov 5, 2015
WellCare

Tampa-based WellCare Health Plans, which manages care for about 800,000 people in Florida's Medicaid program, saw an increase in earnings during the third quarter of the year, according to a filing Wednesday with the federal Securities and Exchange Commission.

Medicare said last week it will pay doctors to help patients plan what kind of care they want at the end of life, an idea more broadly accepted than six years ago, when it touched off a political uproar about “death panels.”

The Justice Department said Friday that it had reached settlements totaling more than $250 million with hundreds of hospitals where doctors implanted cardiac devices in violation of Medicare coverage requirements.

Daylina Miller/Health News Florida

Seniors enrolling in Medicare are facing a tough decision when it comes to which plans they should sign up for.

Anthem reported a 4 percent increase in third-quarter profit and beat Wall Street forecasts as the number of people the health insurer covers edged slightly higher.

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.

Insurers Find Out-Of-Network Bills As Much As 1,400 Percent Higher

Oct 5, 2015

It’s common knowledge that consumers have to pay more money if they choose doctors or hospitals outside of their insurance plan’s network. But a new analysis prepared by the insurance industry seeks to show just how much more in each of the 50 states.

Adventist Health System will pay $115 million to the U.S. Department of Justice to settle claims it offered doctors perks for patient referrals, the Daytona Beach News-Journal reports.

Medicare Yet To Save Money Through Heralded Medical Payment Model

Sep 14, 2015

A high-profile Medicare experiment pushing doctors and hospitals to join together to operate more efficiently has yet to save the government money, with nearly half of the groups costing more than the government estimated their patients would normally cost, federal records show.

A new model of health care run by doctors and hospitals is growing and saving money in the taxpayer-funded Medicare program, according to a new report from the federal government. However, experts say most patients still don’t understand how an Accountable Care Organization works.

White House budget director Shaun Donovan called for a "more aggressive strategy" to thwart improper government payments to doctors, hospitals and insurance companies in a previously undisclosed letter to Health and Human Services Secretary Sylvia Mathews Burwell earlier this year.

Government health care programs covering millions of Americans waste billions of tax dollars every year through these improper payments, Donovan said in the Feb. 26, 2015 letter.

When President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, 1965, Americans 65 and older were the age group least likely to have health insurance.

Here's a bit of good news for Medicare, the popular government program that's turning 50 this week. Older Americans on Medicare are spending less time in the hospital; they're living longer; and the cost of a typical hospital stay has actually come down over the past 15 years, according to a study in the Journal of the American Medical Association.

Under a plea deal with the U.S. Department of Justice, a Miami pharmacist has pleaded guilty to one count of health care fraud for his role in submitting more than $1.8 million in false claims to Medicare, according to a news release from the DOJ. Evelio Fernandez Penaranda, the owner of  Naranja Pharmacy Inc., admitted to submitting claims for Medicare beneficiaries and doctors without their consent.

Wikimedia Commons

Looking at the big picture, the financial health of Social Security and Medicare doesn't appear to have worsened.

Wednesday's annual check-up found that Social Security's retirement trust fund has enough money to pay full benefits until 2035, a year later than previously projected. Medicare's giant trust fund for inpatient care won't be exhausted until 2030, the same date as last year's report.

Daylina Miller/Health News Florida

There are more than 3 million people who have health insurance through Medicare in Florida and dozens of thousands of those beneficiaries could qualify for help paying insurance premiums, deductibles, co-payments and prescriptions, according to the Florida Department of Elder Affairs SHINE program.

Six years ago, a proposal for Medicare to cover end-of-life counseling touched off a political uproar that threatened to stall President Barack Obama's health care law in Congress. Wednesday, when Medicare finally announced it will make the change, reaction was muted.

Five people have been sent to federal prison for their roles in a $25 million Medicare fraud scheme that involved people from Nicaragua and the Dominican Republic posing as U.S. patients.

The sentences imposed last week by a Miami federal judge ranged from 15 months to four years. The five defendants are among 10 who have pleaded guilty after they were charged last year in a 36-count grand jury indictment.

One person, 70-year-old Jose Eloy Sanchez, remains at large and is believed to be in Nicaragua.

Medicare Slow to Adopt Telemedicine

Jun 24, 2015
Lynn Hatter / WFSU

Donna Miles didn’t feel like getting dressed and driving to her physician’s office or to a retailer’s health clinic near her Cincinnati home.

For several days, she had thought she had thrush, a mouth infection that made her tongue sore and discolored with raised white spots. When Miles, 68, awoke on a wintry February morning and the pain had not subsided, she decided to see a doctor.

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