Dental chain may be booted from Medicaid program

By David Heath

Small Smiles, under federal scrutiny for performing unnecessary dental treatments on children, could be barred from the Medicaid program.

Excerpts from this story referencing "Charles Grassley":

"… e, clinic excellence and regulatory compliance,” the company said. Sen. Charles Grassley, R-Iowa, praised the inspector general’s decision. Last year, Grassley e …"

ObamaCare oversight among health watchdog cuts

By Fred Schulte

Trims include ObamaCare oversight

Senate report recommends ouster of large dental chain from Medicaid program

By David Heath

Small Smiles should be removed from Medicaid for encouraging dentists to perform unnecessary treatments to boost profits, investigators say.

Excerpts from this story referencing "Charles Grassley":

"… nderprivileged,” says the 1,500-page, bipartisan report put out by Sens. Charles Grassley, R-Iowa, and Max Baucus, D-Mont. Small Smiles described the report as out …"

Feds tighten scrutiny of health records

By Fred Schulte

Feds increase scrutiny of how electronic systems affect billing

Excerpts from this story referencing "David Kibbe":

"… the government about what is proper as medicine enters the digital era.Dr. David Kibbe, a senior advisor to the American Academy of Family Physicians on digital …"

IMPACT: Cabinet officials signal crackdown on Medicare billing abuse

By Fred Schulte and Joe Eaton

Sebelius, Holder signal new scrutiny in wake of Center series

Excerpts from this story referencing "American Hospital Association":

"… d.”Most of the five groups sent the letter on Monday had no comment. The American Hospital Association said it agreed that upcoding should not be tolerated, but added that “mo …"

"… ical review activities.”The five medical groups sent the letter are: the American Hospital Association, the Association of Academic Health Centers, the National Association of P …"

How doctors and hospitals have collected billions in questionable Medicare fees

By Fred Schulte and David Donald

Center investigation suggests cost from upcoding and other abuses likely tops $11 billion.

Excerpts from this story referencing "researcher":

"… pent with patients didn’t change much over the years. Jerry Cromwell, a researcher with RTI International in North Carolina, in a 2006 study found the averag …"

"… sharp rise in more costly billings. Eric Seiber, an Ohio State University researcher who has studied physician billing trends, said Medicare officials have yet …"

Judgment calls on billing make 'upcoding' prosecutions rare

By Fred Schulte

Authorities typically settle, and doctors often continue treating Medicare patients

Medicare fraud: What you need to know

By Sarah Whitmire

Last week's biggest-ever Medicare fraud bust nabbed 107 care providers, but how does this effort stack up?

Excerpts from this story referencing "Department of Health and Human Services":

"… n March 2007, agencies within the Department of Justice teamed up with the Department of Health and Human Services to create a Medicare Fraud Strike Force. It is a collaboration that became …"

Probe finds hospital chain inaccurately diagnoses infections

By Christina Jewitt and Lance Williams

A California hospital chain under scrutiny over Medicare billing now faces questions about misdiagnoses of a blood infection

Medicare fraud included phantom services, equipment

By Laurel Adams

A sampling of Medicare providers who were overpaid by $206 million in 2007-08 showed some billed the government for phantom services or for

Medicare fraud out of control

By The Center for Public Integrity

Medicare fraud runs rampant but no government crackdown yet, despite bipartisan support