Another whistleblower suit alleges Medicare Advantage fraud

By Fred Schulte

California litigation alleges 'house calls" yielded false claims

Excerpts from this story referencing "Anita Silingo":

"… harge the federal government by $1 billion or more. The suit was filed by Anita Silingo, a former compliance officer for Mobile Medical Examination Services, Inc. …"

Comparison shopping for a health plan

By Wendell Potter

California makes it easy to do your homework.

A call for more scrutiny of private Medicare Advantage plans

By Fred Schulte

Researchers say aggressive billing by private plans may require more scrutiny

Excerpts from this story referencing "Humana":

"… utives of the two biggest Medicare Advantage plans, UnitedHealth Group and Humana, vowed to fight any further rate cuts. The two insurers control about 40 p …"

Obamacare helps millions, but falls short in many ways

By Wendell Potter

The Affordable Care Act has reduced the ranks of the uninsured, but cost of care must be addressed.

New types of health care delivery are improving the 'patient experience'

By Wendell Potter

Commentary: eliminating role of insurers could improve health care delivery.

Health insurers turning into who knows what?

By Wendell Potter

Commentary: health insurers are transforming themselves — but into what?

Black lung disease surges to highs not seen since the '70s, research shows

By Chris Hamby

The likely culprit: a failure by coal mining companies to use readily available tools to control the dust that lodges in miners' lungs.

Excerpts from this story referencing "Coal":

"… Coal dust to improve miners’ health.” Back in 1969, the Federal Coal Mine Health and Safety Act limited the amount of dust allowed in mine …"

Taking insurance companies out of health care

By Wendell Potter

If Boeing experiment flies, health care system could be transformed.

Excerpts from this story referencing "Aetna":

"… ercent in 2012. Mark Bertolini, the CEO of one of the other big insurers, Aetna, was quoted in the article as saying that his company has gotten “very a …"

"… ternational and technology areas. Bertolini has been candid in saying that Aetna no longer sees itself as a traditional insurer. I predict that the big fo …"

Docs, drug companies, insurers drive up Medicare costs

By Wendell Potter

Commentary: reform drove down hospital costs, creating Medicare savings, but insurers, doctors and drug companies escaped cuts.

Excerpts from this story referencing "Medicare Advantage":

"… to provide incentives for health insurance companies to participate in the Medicare Advantage program and administer the Medicare drug program. The Affordable Care Act …"

"… ch themselves, in both lawful and unlawful ways, since the creation of the Medicare Advantage program in 1997.  Under this program, Medicare pays privately run he …"

"… CPI investigation uncovered as much as $70 billion of improper payments to Medicare Advantage plans from 2008 through last year. Will Congress act to save taxpayers bi …"

Dire predictions of endless waits for a doctor have proven unfounded

By Wendell Potter

Commentary: Obamacare has not resulted in long waits for a doctor.

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "Obama administration":

"… apitol Hill and has successfully fought back efforts by the Obama administration to make substantial cuts to its payment rates. Lobbying by the insurance i …"

Critic of artificial sweeteners pilloried by industry-backed scientists

By Chris Young

Any criticism of the artificial sweetener industry is met with a barrage of criticism, often from questionable sources.

Excerpts from this story referencing "California":

"… Carolyn de la Pena, a professor of American studies at the University of California at Davis, wrote in her 2010 book “Empty Pleasures: The Story of Artifici …"

Black lung claims by 1,100 coal miners may have been wrongly denied

By Chris Hamby

Black lung opinions by Dr. Paul Wheeler of Johns Hopkins should be assumed to lack credibility, senators are told at a hearing.

Excerpts from this story referencing "Center for Public Integrity":

"… earing were both prompted by a series of stories released last year by The Center for Public Integrity in partnership with ABC News.   Miners who get black lung, a debili …"

"… k to you all to help us."   Chris Hamby, a former reporter with the Center for Public Integrity, now works for BuzzFeed. …"

Families sick from fracking turn to scientists

By Lisa Song

A Pennsylvania nonprofit provides free health consultations to people who live near gas drilling sites and complain of health effects.

Excerpts from this story referencing "Department of Health":

"… r local health departments. InsideClimate News contacted the Pennsylvania Department of Health multiple times over a two-week period to ask how it manages the public hea …"

Even low doses of arsenic trigger cancer in mice, study finds

By David Heath

Study by the National Institutes of Health found levels of arsenic similar to what some people consume caused cancer in mice.

Excerpts from this story referencing "Environment":

"… rs in history. Extrapolating from those studies, scientists with the U.S. Environmental Protection Agency have tentatively concluded that arsenic is a serious p …"

"… pears to be safe,” Linda Birnbaum, director of the National Institute of Environmental Health Sciences and the National Toxicology Program, said in a statement …"

What to do if your drinking water contains arsenic

By David Heath

Millions of Americans unwittingly consume arsenic, a potent carcinogen also linked to IQ deficits in children, in their drinking water.

Excerpts from this story referencing "U.S. Environmental Protection Agency":

"… s crust, and it finds its way into food, water, soil and air. In 2000, the U.S. Environmental Protection Agency considered tightening the drinking water standard for arsenic — then at …"

Praise for UK-style health system vindicates spurned nominee

By Wendell Potter

Former Medicare chief's support for UK's health care system may win votes in race for governor of Massachusetts.

Home is where the money is for Medicare Advantage plans

By Fred Schulte

Medicare Advantage home visits may not improve health, but boost risk scores and cost taxpayers billions.

Excerpts from this story referencing "Massachusetts":

"… their services as “revenue optimization.” Predilytics, a Burlington, Massachusetts, health information analytics firm, markets software to Medicare Advantage …"

Health insurers have their way with regulators

By Fred Schulte

Billions in Medicare Advantage overpayments likely gone for good.

Excerpts from this story referencing "America’s Health Insurance Plans":

"… s will be effective,” said Clare Krusing, director of communications for America’s Health Insurance Plans, the industry trade group. Padded bills  Under the traditional Medic …"

Labor Department issues warning about Hopkins doctor's findings on black lung claims

The U.S. Department of Labor warned its officials to view with skepticism any X-ray readings by Dr. Paul Wheeler of Johns Hopkins.

Excerpts from this story referencing "disease":

"… pkins University doctor who virtually never diagnoses black lung, a deadly disease that afflicts coal miners. The news organizations reported last fall that …"

"… claims for federal benefits, had never found the most severe form of the disease among more than 1,500 claims. Johns Hopkins suspended its black lung X-ray …"

Why Medicare Advantage costs taxpayers billions more than it should

By Fred Schulte, David Donald and Erin Durkin

Critics warned of billing abuse in Medicare Advantage health plans, but oversight is lagging.

Excerpts from this story referencing "George W. Bush":

"… r later. Thomas Scully, who helped get the program running under President George W. Bush, said rates were generous in hopes of enticing insurers to expand their Me …"

Medicare Advantage made simple: a glossary

By Fred Schulte

Definitions for lesser-known terms relating to Medicare.

Excerpts from this story referencing "disease":

"… e visits also can be profitable for the health plans when they uncover new diseases that raise a patient’s risk score— even if the health plan provides n …"

"… In other words, a health plan cannot just write down that a patient has a disease and seek extra payments from Medicare. The plan must also show that its do …"

"… ulation that would have banned home health assessments which uncovered new diseases but didn’t lead to any more treatment. Retrospective Chart Reviews:&nb …"

"… s” electronic patient medical files looking for evidence of unrecognized diseases that could boost risk scores and Medicare payments. CMS has proposed that …"

Center sues in an effort to make Medicare Advantage files public

By Fred Schulte

Center sues to make records public.

Forcing health insurers to do what's right

By Wendell Potter

Commentary: Policyholders benefit from Obamacare provision.

A different way of thinking about health care

By Wendell Potter

Commentary: Canadians take pride in their health care system.

Keeping an eye on insurance companies that refuse to pay claims

By Wendell Potter

Commentary: Arizona case resolved after victim became a 'squeaky wheel'

The Canadian health care system I disparaged

By Wendell Potter

Commentary: health care system up north is more efficient.

Be the 'squeaky wheel' if health claim denied

By Wendell Potter

Commentary: Obamacare may squeeze insurance industry profits, subscribers should know their rights when it comes to claim denials.

Excerpts from this story referencing "Maryland":

"… service in question — winning as many as 54 percent of such decisions in Maryland, for example,” CPR reported. Bottom line here: With profit margins unde …"

American-style health care system pushed in Canada

By Wendell Potter

Canada's conservative Prime Minister Stephen Harper wants to remake nation's health care system.

GOP opposition to Obamacare baffles Dr. Sullivan

By Wendell Potter

Commentary: former HHS Secretary Sullivan says Obamacare resembles plan crafted by Republicans.

Pages