Court case pushed by think tank could leave uninsured out in the cold

By Wendell Potter

Supreme Court case backed by think tank hinges on single sentence in Affordable Care Act.

Excerpts from this story referencing "Washington":

"… what the cost, so be it, say the folks at a libertarian influence shop in Washington. When the high court announced earlier this month that it would decide a …"

"… heir health insurance, it was time for high-fives at the Cato Institute in Washington. Cato’s director of health policy studies, Michael Cannon, has argued f …"

Obama administration let opponents define the Affordable Care Act

By Wendell Potter

Commentary: Obama administration let foes define Affordable Care Act.

Excerpts from this story referencing "insurance":

"… th about why reform was needed and how the final law would protect us from insurance industry abuses. Which, fortunately, it does. The problem is that most Ame …"

"… are system is not just a problem for the uninsured. Those who do have insurance have never had less security and stability than they do today. More a …"

"… at if you move, lose your job, or change your job, you'll lose your health insurance too. More and more Americans pay their premiums, only to discover that the …"

"… o. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the fu …"

Health insurers win midterm election!

By Wendell Potter

Commentary: midterm results create a friendlier Congress.

Excerpts from this story referencing "Insurance":

"… erstand that isn’t likely to happen. And they really don’t want it to. Insurance firms and their shareholders actually love the billions of dollars in new …"

"… ay to the bank. Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and …"

More scrutiny coming for Medicare Advantage, Obamacare

By Fred Schulte

New round of audits coming; Obamacare too.

Excerpts from this story referencing "Inspector General":

"… ng under the Affordable Care Act. The Health and Human Services Office of Inspector General, which investigates Medicare and Medicaid waste, fraud and abuse, said it …"

"… es with an eye toward curbing overcharges. Results are due next year. The Inspector General also announced from five to ten new audits into Obamacare, ranging from th …"

"… ayments for new enrollees to controls to prevent fraudulent sign ups. The Inspector General’s office did not say if individual Medicare Advantage plans would be aud …"

"… n does not always support the diagnoses” (used to bill Medicare),” the Inspector General said. “Efforts for FY 2015 and beyond may include additional work examin …"

Another whistleblower suit alleges Medicare Advantage fraud

By Fred Schulte

California litigation alleges 'house calls" yielded false claims

Excerpts from this story referencing "Oregon":

"… isits to Medicare Advantage patients in Ohio, New York, California, Texas, Oregon and Virginia.   The four health plans “turned a blind eye to the tr …"

GAO takes on Medicare Advantage spending

By Fred Schulte

GAO will investigate program spending.

Excerpts from this story referencing "Congress":

"… subsidiary of New-Jersey based Aveta, Inc., denied the allegations. …"

"… ars every year. The Government Accountability Office, the watchdog arm of Congress, is conducting the probe at the request of the House Ways and Means Commit …"

"… care Advantage has grown explosively under the risk-scoring formula, which Congress put in place in 2004. Officials expect the program to cost taxpayers as mu …"

"… essive. The Medicare Advantage industry has enjoyed bipartisan support in Congress as the program has grown. In recent years, the industry has successfully l …"

Comparison shopping for a health plan

By Wendell Potter

California makes it easy to do your homework.

Excerpts from this story referencing "Gray Davis":

"… ver it or go to the trouble of seeking it out. Back in 2000 when Democrat Gray Davis was governor, California began operating an agency called the Office of Th …"

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 "Washington":

"… ect scam,” said Patrick Burns, co-director of Taxpayers Against Fraud in Washington. “You simply systematically up-code conditions and that results in massi …"

"… g involved, the Medicare Advantage payment dispute is the sort of issue in Washington that barely registers outside of a small circle of policy wonks and indust …"

"… y lobbyists, who often rule the day in influencing government policy. In a Washington meeting last week, executives of the two biggest Medicare Advantage plans, …"

California coverage plan for undocumented echoes earlier call by Schwarzenegger

By Wendell Potter

Commentary: former governor supported plan allowing coverage for undocumented residents.

Excerpts from this story referencing "Arnold Schwarzenegger":

"… olks hanging off the sides of the ship." …"

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.

Excerpts from this story referencing "Insurance":

"… years to come. Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and …"

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

By Wendell Potter

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

Excerpts from this story referencing "Insurance":

"… ue to drive it. Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and …"

Health insurers turning into who knows what?

By Wendell Potter

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

Excerpts from this story referencing "Florida":

"… tions.” Even the nonprofit Blue Cross plans are reinventing themselves. Florida’s largest insurer, Florida Blue, earlier this month unveiled its new cor …"

"… Blue Cross plans are reinventing themselves. Florida’s largest insurer, Florida Blue, earlier this month unveiled its new corporate parent, GuideWell. Sai …"

"… Medifuture conference in Tampa: “We’re not here to be the best plan in Florida. We’re here to be the best health solutions company in the Uni …"

Defeat of California initiative would protect insurers' profits

By Wendell Potter

Proposition 45 would allow California's insurance chief to block insurance rate hikes; insurers are spending millions to kill it.

Excerpts from this story referencing "Barack Obama":

"… ent last week on an ad in Salon.com featuring a large picture of President Barack Obama and this message: “Protect Obamacare from Legal Attacks. Prop 45’s Dir …"

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 "Henry Waxman":

"… rmaceutical companies and health insurers. Some lawmakers, including Rep. Henry Waxman, D-Calif., and Sen. Jay Rockefeller, D-W.Va., wanted to include language i …"

Medicare Advantage patients find themselves in regulatory limbo

By Fred Schulte

States lack oversight but feds are struggling to keep with fast-growing health plans.

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.

Excerpts from this story referencing "physician":

"… ealing Obamacare, Congress would lift a freeze in Medicare’s support for physician-training positions that has been in effect since 1997. It’s true that t …"

"… e do have a rapidly growing supply of mid-level medical providers — like physician assistants and nurse practitioners — who now treat many of our health pr …"

"… o was able to prescribe medications. Thousands of nurse practitioners and physician assistants are joining the medical work force every year. According to the …"

"… edical work force every year. According to the Bureau of Labor Statistics, physician assistants — who can do anything from physical exams to ordering lab tes …"

Ten major findings from our investigations so far this year

By Jared Bennett and Sarah Whitmire

Investigations from the first half of 2014

Excerpts from this story referencing "judge":

"… having tobacco This is judge Tim Irwin of Tennessee. As a juvenile court judge, he is admired for kind gestures like handing out stuffed animals to small …"

"… ough New York’s luxury real estate. Keep reading 8. Sixteen high court judges ruled in 26 cases despite having a financial conflict More than half of …"

"… despite having a financial conflict More than half of federal appellate judges, arbiters of the second-highest court in the U.S., reported owning stock …"

"… -highest court in the U.S., reported owning stock in 2012. We wondered how judges were keeping track of their holdings when cases involved a company they'd …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "spokeswoman":

"… ll. About 70 medical conditions can boost payment rates. Clare Krusing, a spokeswoman for America’s Health Insurance Plans, the industry’s trade group, said …"

Obamacare-driven competition lowering rates in some states

By Wendell Potter

Commentary: much-maligned Affordable Care Act attracting for-profit insurers, driving prices down in some states.

Excerpts from this story referencing "Oregon":

"… both of which are saying they will reduce premiums for 2015 coverage. Oregon: Oregon’s Health CO-OP is seeking a 16 percent decrease in premiums for …"

"… which are saying they will reduce premiums for 2015 coverage. Oregon: Oregon’s Health CO-OP is seeking a 16 percent decrease in premiums for its gold …"

"… roposing to increase rates for comparable coverage by 13 percent. Overall, Oregon’s Health CO-OP says it plans to cut premiums by 21 percent. Residents …"

Attack ads may actually be benefiting Obamacare enrollment

By Wendell Potter

Publicity from attacks may actually help hike enrollment.

Excerpts from this story referencing "Oregon":

"… decreased 7.10 points, Kentucky 8.35 points, Rhode Island 8.73 points and Oregon 10.54 points. Red West Virginia saw its rate drop the most: 10.74 points. …"

Feds seek new authority to recoup Medicare Advantage overcharges

By Fred Schulte

Impact: Feds act to recoup overcharges following Center investigation.

Medicare Advantage plans require more scrutiny

By Fred Schulte

Government inspector says private Medicare plans difficult to investigate due to lack of access to data.

Excerpts from this story referencing "Health":

"… or says. Gary Cantrell, a deputy Inspector General with the Department of Health and Human Services said reviews are “hampered by a lack of accurate, tim …"

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.

Excerpts from this story referencing "United Kingdom":

"… s would stage a filibuster. Berwick’s sin: expressing admiration for the United Kingdom’s single-payer health care system in a 2008 speech commemorating the 60t …"

Health insurance lobby keeps Medicare Advantage overpayments flowing

By Wendell Potter

Commentary: program bills are excessive, but don't expect reforms.

Excerpts from this story referencing "Medicaid":

"… ry source was quoted as saying that, "If CMS (the Centers for Medicare and Medicaid Services) doesn't keep Medicare Advantage payment rates flat next year, it …"

Get involved: Help Medicare Advantage investigation go further with donations and news tips

Join us in finding problems with Medicare Advantage billing, “risk scores”, or home visits.

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 "Insurance":

"… ni, president of the industry’s powerful trade group, America’s Health Insurance Plans, in a March 7, 2014 letter to CMS argued that the agency had shown n …"

"… axpayers billions of dollars. A report commissioned by America’s Health Insurance Plans predicted in February that limiting home visits would shav …"

Medicare Advantage lobbying machine steamrolls Congress

By Fred Schulte

Under pressure, Medicare Advantage critics morph into defenders.

Excerpts from this story referencing "Center for Responsive Politics":

"… s industry over the past three election cycles, according to data from the Center for Responsive Politics. Franken alone has received at least $90,000 from the health services indu …"

Skyrocketing salaries for health insurance CEOs

By Wendell Potter

Commentary: soaring compensation, rising stock prices don't justify higher premiums.

Excerpts from this story referencing "Management":

"… 11 companies (Aetna, Centene, Cigna, Health Net, Humana, Molina, Triple-S Management Corp., UnitedHealth Group, Universal American, Wellcare, and WellPoint) ni …"

Health insurers have their way with regulators

By Fred Schulte

Billions in Medicare Advantage overpayments likely gone for good.

Excerpts from this story referencing "Government":

"… are accurate. James Cosgrove, who directs the health care division of the Government Accountability Office, the watchdog arm of Congress, said that federal hea …"

New audits may recover missing millions — or not

By Fred Schulte

Secretive audits target some Medicare Advantage plans.

Excerpts from this story referencing "Inspector General":

"… rt of the Department of Health and Human Services (HHS). The HHS Office of Inspector General, which acts as a watchdog over CMS, has done some of its own audits of Med …"

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