Medicare

AHIP

A report from America’s Health Insurance Plans shows that of out-of-network fees can be as much as 100 times greater than what Medicare pays, the New York Times reports.

The report pegs Florida as one of the worst offenders, according to the Times.

Medicare Fraud Focus of Raid on Eye Doctor’s Clinic

Jan 31, 2013

On top of accusations that he provided free trips and possibly underage prostitutes for Senator Bob Menendez, South Florida eye surgeon Salomon Melgen is now being investigated for Medicare fraud, the Miami Herald reports.

Gionfriddo: Reform Costs, Not Entitlements

Jan 23, 2013

Health consultant Paul Gionfriddo writes that the myth of entitlement reform may go by the wayside. The problem, he writes, isn’t the cost to the government, but the increasing cost to the individuals who rely on the programs.
 

Wollschlaeger: Sweet Deal For Drugmaker At Taxpayer Cost

Jan 22, 2013

In "Fiscal Footnote: Big Senate Gift to Drug Maker,” the New York Times reported that key Senate lawmakers inserted a paragraph into Section 632 of the “fiscal cliff” bill which essentially delays a set of Medicare price restraints on a class of drugs that includes Sensipar, a lucrative Amgen pill used by kidney dialysis patients.

Roche

The company that serves as Medicare's paymaster in Florida overpaid 78 percent of the claims for one breast-cancer drug over three years, according to an audit released Friday by the Department of Health and Human Services.

First Coast Service Options Inc. of Jacksonville's overpayments for the drug Herceptin amounted to $1.3 million, the audit report from the HHS Office of Inspector General says.

Residents of a nursing home in St. Petersburg are livid over a change in policy that limits them to nine 20-minute smoke breaks a day. The facility says it changed the rules after federal health officials sent a letter about a nursing-home patient who died after her cigarette lit her clothes on fire.

Orlando Sentinel

 

Jacksonville-based American Sleep Medicine LLC will pay the fine to settle charges that it billed government programs for sleep studies that were performed by unlicensed technicians.

Late on Tuesday, the House joined the Senate in approving a temporary fix to undo the "fiscal cliff" -- automatic tax hikes and spending cuts that went into effect on Tuesday. President Barack Obama told the nation shortly after 11 p.m. that he would quickly sign the measure into law.

While most of the attention was focused on avoiding big tax increases and maintaining unemployment benefits, the deal spelled a major relief to physicians, while imposing a worry on hospitals.

ProPublica’s Nursing Home Inspect has been improved to make it easier for the public to see inspection reports and the rating on an A to L scale. Most facilities are rated “D.”

Keilan Fife and two other young adults were arrested on charges of defrauding Medicare of over $26 million by paying kickbacks and bribes to patients and others.

How to trim Medicare?

Nov 16, 2012

The White House will want to protect Medicaid and the health law from budget cuts, making Medicare a likely target. Kaiser Health News lays out options.

Would you hospitalize a patient with bronchitis? Medicare auditors say no. What if she were 99, near death? Hospitals ask: Shouldn't that make a difference?

President Obama's lead on Medicare has shrunk to the margin-of-error zone, even in senior-rich states like Florida.

In a week or two, seniors enrolled in certain Medicare health plans and drug plans will get a letter from the federal government. It is not good news.

The Centers for Medicare and Medicaid Services (CMS) letter will say their plan is substandard, "rated 'poor' or 'below average' for at least the last three years."

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