In a Major Shift, Medicare Authorities Seek Power to Ban Harmful Prescribers
Medicare plans to arm itself with broad new powers to better control—and potentially ban—doctors engaged in fraudulent or harmful prescribing, following a series of articles by ProPublica detailing lax...
View ArticleIf We’re Going to Go After Dirty Doctors, We Need a Definition for ‘Abusive’...
When the agency that runs Medicare announced that it would take action against doctors who prescribe abusively in its massive drug program—perhaps banning them—it raised an interesting question. What...
View ArticleOur Patient-Harm Problem: One Third in Nursing Facilities Harmed by Treatment
One-in-three patients in skilled nursing facilities suffered a medication error, infection, or some other type of harm related to their treatment, according to a government report that underscores the...
View ArticleMedicare’s Drug Program Needs Stronger Protections Against Fraud
Medicare has failed to adequately track fraud in its massive prescription drug program, according to a new report from the agency’s watchdog. In particular, the inspector general of the U.S. Department...
View ArticleSmoking Mad: Tobacco Users Caught Up in Insurer’s Obamacare Glitch
Retired New Hampshire nurse Terry Wetherby doesn’t hide the fact that she smokes. She checked the box on HealthCare.gov saying she uses tobacco and fully expected to pay more for her insurance policy...
View ArticleClik here to view.
A Better Way to Pick the Doctor That’s Right for You
Last week, the federal government made plans to release a massive database capable of providing patients with much more information about their doctors. The Centers for Medicare and Medicaid Services,...
View ArticleClik here to view.
Even After Doctors Are Sanctioned or Arrested, Medicare Keeps Paying
In August 2011, federal agents swept across the Detroit area, arresting doctors, pharmacists, and other health professionals accused of running a massive scheme to defraud Medicare. The following...
View ArticleClik here to view.
The High Cost of Living With Cancer
Bristol-Myers Squibb was the darling of Wall Street recently, with an impressive five percent increase in first-quarter revenue to $3.63 billion. Its research and development cost in that same quarter...
View ArticleClik here to view.
Top Billing: Meet the Doctors Who Charge Medicare Top Dollar for Office Visits
Office visits are the bread and butter of many physicians’ practices. Medicare pays for more than 200 million of them a year, often to deal with routine problems like colds or high blood pressure. Most...
View ArticleClik here to view.
Medicare Finally Tightens the Reins on Its Drug Program
The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier...
View ArticleClik here to view.
Why Is Medicare Overpaying Billions for Office Visits and Patient Evaluations?
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....
View ArticleClik here to view.
Digging Through the Medicare Data Dump: Billing Outliers Often Have...
Over the past couple months, media organizations including ProPublica have been busy dissecting data released by Medicare on payments made to health professionals in 2012. We’ve uncovered unusual...
View ArticleClik here to view.
Health Care Is a Huge Business, but It’s Not the Doctors Who Are Making the...
When my primary care physician, a wonderful doctor, told me he was retiring, he said, “I just can’t practice medicine anymore the way I want to.” It wasn’t the government or malpractice lawyers. It was...
View ArticleClik here to view.
How a Fanny Pack Mix-Up Unraveled a Massive Medicare Fraud Scheme
The fraud scheme began to unravel last fall, with the discovery of a misdirected stack of bogus prescriptions—and a suspicious spike in Medicare drug spending tied to a doctor in Key Biscayne, Florida....
View ArticleClik here to view.
Why Are Obstetricians Among the Top Billers for Group Psychotherapy in Illinois?
A few years ago, Illinois’ Medicaid program for the poor noticed some odd trends in its billings for group psychotherapy sessions. Nursing home residents were being taken several times a week to...
View Article