Medicare

The House voted Tuesday to kill a federal panel that is supposed to find ways to curb Medicare spending, as Republicans ignored a veto threat and leveled their latest blow at President Barack Obama's health care overhaul.

Members of the Independent Payment Advisory Board have never been appointed, and the panel has never recommended savings from Medicare, the $600-billion-a-year health care program for the elderly.

Study: 19 Million Uninsured If Law Repealed

Jun 22, 2015
U.S. Supreme Court

Repealing the federal health law would add an additional 19 million to the ranks of the uninsured in 2016 and increase the federal deficit over the next decade, the Congressional Budget Office said Friday.

Eastlakeoncology.com

 A Florida oncologist was charged Thursday with giving cancer patients medications, including chemotherapy drugs, from other countries that were not approved by the federal Food and Drug Administration.

Justices Decline Baker County Hospital Case

May 19, 2015
Baker County Medical Services

The U.S. Supreme Court on Monday turned down an appeal by a small North Florida hospital in a case that centered on payments for treating federal detainees. Justices declined to hear the appeal from Ed Fraser Memorial Hospital, a 25-bed facility in Baker County.

Gov. Rick Scott on Monday announced his nine appointments to a commission tasked with examining hospital finances, naming only one health care professional to the commission and a chair that has been a frequent donor to the governor and other Republican causes.

The governor has gone on the attack against hospitals over a fight to expand Medicaid and extend federal funds that help hospitals who care for Medicaid and uninsured patients. The issue is creating a potential $1 billion hole in the state budget.

Florida Hospital

 The Inspector General at the Department of Health and Human Services claims that Florida Hospital owes the federal government $11.5 million in Medicare overpayments made between January of 2011 and June of 2012, according to the Orlando Sentinel

New momentum for a lasting fix to Medicare's doctor-payment problem shows that lawmakers may finally be recognizing what has long bothered their constituents.

Year after year, the threat of 20 percent payment cuts averted at the last minute has seemed a curious way to run a program that lives depend on.

Associated Press

 An extraordinary bipartisan accord between House Speaker John Boehner and Minority Leader Nancy Pelosi is letting both parties exhale as they move toward ending the nagging annual threat of Medicare cuts to physicians. Yet each side is bragging about far more than that.

U.S. House of Representatives

A budding bipartisan deal to shelter physicians from Medicare cuts, championed by the House's two top leaders, is drawing powerful allies including the American Medical Association and a rainbow of conservative and liberal groups.

Daylina Miller/WUSF News

The need to reduce patient readmission rates is leading hospitals across Florida to share ideas with one another.  

Federal authorities haven’t publicly accused taxpayer supported Broward Health of submitting bogus claims to Medicare and Medicaid, but the health system still has racked up a $10.2 million tab for legal advice, the Florida Bulldog reports.

The younger brother of a man accused of laundering $238 million in Medicare dollars from Florida to Cuba's banking system was sentenced to 3 1/2 years in federal prison on Wednesday, the Miami Herald reports.

Eduardo Perez de Morales was barely an adult when his brother recruited him into the scheme, but he admitted he continued with the partnership even after realizing it was illegal, the Herald reports. 

  The White House is holding the first in a series of forums to hear about the most important issues facing older Americans. 

The event Thursday in Tampa comes amid a historic demographic shift in the U.S. as the massive baby boom generation moves closer to old age.

Wikimedia Commons

 A Pembroke Pines resident was sentenced Thursday to 17 years in prison stealing the identities of physicians and filing false claims to Medicare, the South Florida Business Journal reports.

The. U.S. Attorney’s Office in Miami said Alejandra Collazo forged prescriptions for services not ordered by physicians and accepted payments through her clinic, Vortex Medical Center & Management Services of Hialeah.

Wikimedia Commons

Some physicians are starting to warn their patients who winter in Florida that physicians may be ordering tests they don’t need, the New York Times reports. 

Medicare data show that some doctors in Florida have been ordering tests at twice the rate of doctors in Massachusetts, according to analysis by the Times

HHS Quickens Pace to Quality-Based Medicare Pay

Jan 27, 2015
Kaiser Health News

The Obama administration Monday announced a goal of accelerating changes to Medicare so that within four years, half of the program’s traditional spending will go to doctors, hospitals and other providers that coordinate their patient care, stressing quality and frugality.

Solid economic growth will help the federal budget deficit shrink this year to its lowest level since President Barack Obama took office, according to congressional estimates released Monday.

The Congressional Budget Office also projects a 14 percent drop in the number of U.S. residents without health insurance, largely because of Obama's health law.

Hospitals Win Quality Bonuses From Medicare, But Most Will Never Collect

Jan 22, 2015

 Medicare is giving bonuses to a majority of hospitals that it graded on quality, but many of those rewards will be wiped out by penalties the government has issued for other shortcomings, federal data show.

See the data for hospitals in Florida here. 

HealthCare.gov

A little-known side to the government's health insurance website is prompting renewed concerns about privacy, just as the White House is calling for stronger cybersecurity protections for consumers.

Adjusting medications before someone gets sick enough to visit the doctor. Updating outside specialists so one doctor's prescription doesn't interfere with another's.

Starting this month, Medicare will pay primary care doctors a monthly fee to better coordinate care for the most vulnerable seniors — those with multiple chronic illnesses — even if they don't have a face-to-face exam.

The goal is to help patients stay healthier between doctor visits, and avoid pricey hospitals and nursing homes.

Florida Accountable Care Services

The former owners of the now-defunct Physician United Plan have dropped a lawsuit that accused the accountants who worked for the Medicare Advantage plan of hiding its financial woes from state regulators, the Ocala Star-Banner reports.

Prolific Prescribers Of Controlled Substances Face Medicare Scrutiny

Dec 15, 2014

Despite a national crackdown on prescription drug abuse, doctors churned out an ever-larger number of prescriptions for the most-potent controlled substances to Medicare patients, new data show.

In addition, ProPublica found, the most prolific prescribers of such drugs as oxycodone, fentanyl, morphine and Ritalin often have worrisome records.

The veteran business executive hired by Florida Healthcare Plus is trying to repair the image of the firm after six former employees were indicted for their role in an international, $25 million Medicare and Medicaid scam, the Miami Herald reports.

In an interview, Susan Rawlings Molina says no one else at the company knew about the fraud, except for the ex-employees who are now facing charges. Only the former workers, not the company, are accused of wrongdoing.

U.S. Health Spending Growth Lowest Since 1960

Dec 4, 2014

National health spending grew 3.6 percent in 2013, the lowest annual increase since the Centers for Medicare and Medicaid Services (CMS) began tracking the statistic in 1960, officials said Wednesday.

Spending slowed for private health insurance, Medicare, hospitals, physicians and clinical services and out-of-pocket spending by consumers.  However, it accelerated for Medicaid and for prescription drugs, according to the report, published online by the journal Health Affairs.

A whistleblower’s lawsuit by an ex-Plaza Health Network executive alleges that false claims were submitted to Medicare and Medicaid to the tune of $130 million, the Broward Bulldog reports.

(Editor's Note: It's Medicare enrollment season, now through Dec. 7, and beneficiaries are trying to decide on a plan. Health News Florida’s Carol Gentry, who has covered Medicare for many years, is seeing the federal program from a new point of view: as a beneficiary. Her first commentary, which aired Oct. 9, was "Medicare's Complexity Can Be Scary." The second one, "Which Medicare Path Do I Take?" is below).

Few Obese Seniors Using Medicare Benefit

Nov 20, 2014
Associated Press

Three years ago, the Obama administration offered hope to millions of overweight seniors when it announced Medicare would offer free weight-loss counseling.

Officials estimated that about 30 percent of seniors are obese and therefore eligible for counseling services, which studies have shown improve the odds of significant weight loss.

Hospitals Taking Cues From Hospitality

Nov 5, 2014

Two years ago, Inova Health System recruited a top executive who was not a physician, had never worked in hospital administration and barely knew the difference between Medicare and Medicaid.

What Paul Westbrook specialized in was customer service. His background is in the hotel business – Marriott and The Ritz-Carlton, to be precise.

Medicare said it will consider paying doctors to counsel patients about their options for end-of-life care, the same idea that spurred accusations of "death panels" and fanned a political furor around President Barack Obama's health care law five years ago.

The announcement came late last week in a voluminous regulation on physician payment. It will "give the public ample opportunity to weigh in on the topic," said Medicare spokesman Aaron Albright.

Medicare will consider a change for 2016.

University of Miami Miller School of Medicine

Behind the scenes at the University of Miami’s Bascom Palmer Eye Institute, two top physicians feuded so badly over just about everything that a "personality coach" was hired to try to soothe tensions. 

But as the Miami Herald reports, the two stars couldn’t coexist; and after one of the doctors left Bascom Palmer, he turned in the other over allegations of Medicare fraud.

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