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OPINION: making the tough health care calls

By Wendell Potter

Independent Payment Advisory Board may be best hope for trimming costs, eliminating unnecessary procedures.

Excerpts from this story referencing "Medicaid":

"… o Medicare. Even though the program is run by the Centers for Medicare and Medicaid Services, members of Congress frequently exert their influence over that a …"

"… dical procedures and devices paid for by taxpayers to cover state workers, Medicaid recipients and the people receiving benefits through the state’s workers …"

Clinton supporter suspected of illegal donations

By Alan Suderman and Ben Wieder

Clinton's 2008 campaign received $50,000 from "assembly line of illegal campaign contributions."

Excerpts from this story referencing "Medicaid":

"… ion since 2001, according to USAspending.gov. D.C. Chartered Health was a Medicaid managed-care organization that contracted with the city to provide health …"

High court upholds key part of Obama health law

By The Associated Press

ObamaCare's individual mandate survives Supreme Court as a tax.

Excerpts from this story referencing "Medicaid":

"… irness," Roberts said.The court found problems with the law's expansion of Medicaid, but even there said the expansion could proceed as long as the federal go …"

"… ong as the federal government does not threaten to withhold states' entire Medicaid allotment if they don't take part in the law's extension.The court's four …"

"… the purchase of health insurance and in denying non-consenting states all Medicaid funding."In all, the justices spelled out their views in six opinions tota …"

"… l budget woes will force them to confront painful options for Medicare and Medicaid, the giant federal programs that cover seniors, the disabled, and low-inco …"

Is Michael Jackson's doctor disqualified from Medicare? Or are two senators mistaken?

By Joe Eaton

Obama admin. disputes senators' contention that Michael Jackson's physician still eligible to bill Medicare

Excerpts from this story referencing "Medicaid":

"… d him to be immediately kicked out of the program.Centers for Medicare and Medicaid spokesman Brian Cook said the senators are mistaken. Conrad’s “enrollm …"

Analysis — Are seniors paying attention to Paul Ryan's plan for Medicare?

By Wendell Potter

ANALYSIS: Republicans sold seniors a bill of goods on health care reform and Medicare

Excerpts from this story referencing "Medicaid":

"… rt of reform that would require all Americans not eligible for Medicare or Medicaid to buy coverage from them, they did not like the provision that would elim …"

Analysis — Insurers’ ‘friends’ will influence public option debate in Conn.

By Wendell Potter

Health insurers in Connecticut will call on some of their longtime allies to help turn the public and state lawmakers against the idea of cr

Excerpts from this story referencing "Medicaid":

"… ting in 2014 for a prospective pool of recipients including state workers, Medicaid recipients, individuals and small businesses. A similar public option wa …"

GOP opposition to Obamacare baffles Dr. Sullivan

By Wendell Potter

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

Excerpts from this story referencing "Medicaid":

"… ce plan if they are not eligible for a government program like Medicare or Medicaid — is among the most vilified by today’s GOP. “If they were supporti …"

"… orgia, where Sullivan was born and still lives, have refused to expand the Medicaid program to bring more low-incomes individuals and families into coverage, …"

"… erage, as the Affordable Care Act makes possible. Deal has said expanding Medicaid “is something our state cannot afford,” even with the federal governme …"

"… urnalists Thursday that, in his view, Georgia can’t afford not to expand Medicaid. Not only would the expansion bring hundreds of thousands of Georgians int …"

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 "Medicaid":

"… April 3, 2014: Small Smiles will no longer be allowed to serve patients on Medicaid started Sept. 30, affecting hundreds of thousands of children, the inspect …"

"… t doesn't plan to appeal the decision, which will bar the company from the Medicaid program for five years. Small Smiles, which has been under federal scruti …"

"… orming unnecessary dental treatments on children, could be barred from the Medicaid program beginning next month. The inspector general of the Department of …"

"… new dentist willing to treat them. Small Smiles will be excluded from the Medicaid program in early April unless it appeals the decision. The owner of the co …"

Pay no attention to those insurance lobbyists behind the Medicare curtain!

By Wendell Potter

Commentary: 'grass-roots' campaign actually comes from health insurers.

Excerpts from this story referencing "Medicaid":

"… k ever since trying to figure out how to keep the Centers for Medicare and Medicaid Services  (CMS) from carrying out that provision of the law. And for …"

Selective outrage over federal health care costs

By Wendell Potter

Commentary: Conservatives slam risk fund for insurers, but have nothing to say about Medicare Advantage.

Excerpts from this story referencing "Medicaid":

"… Government Accountability Office explains it, the Centers for Medicare and Medicaid Services (CMS) adjusts the monthly payments it sends to private insurers t …"

Obamacare and emergency rooms: a bit of perspective needed

By Wendell Potter

Commentary: Oregon study cited by critics requires perspective.

Excerpts from this story referencing "Medicaid":

"… adlines based on a study of emergency room visits by a few thousand Oregon Medicaid beneficiaries undoubtedly gave the Obama administration heartburn last wee …"

"… a administration heartburn last week. Although the study predated the Medicaid expansion authorized by the Affordable Care Act — which began in some st …"

"… Oregon study jumped to the conclusion that the millions of newly enrolled Medicaid beneficiaries would make greater — not less — use of the ER for routin …"

"… ery. Many Oregonians who had been on a waiting list for the state’s Medicaid program got lucky when their names were drawn and they were added to the r …"

As glitches fade, Obamacare approval will rise

By Wendell Potter

Commentary: as website improves, customers are finding insurance deals.

Excerpts from this story referencing "Medicaid":

"… while state officials checked to see if the applicants were eligible for Medicaid. Smith knew her income was too high to qualify for Medicaid, but she neve …"

"… eligible for Medicaid. Smith knew her income was too high to qualify for Medicaid, but she nevertheless had to fill out an extensive questionnaire and was p …"

"… active supporter of health care reform.   After she finally got the Medicaid denial she was expecting, Smith called Connect for Health Colorado — the …"

"… an employee to complete her application. “If people can get through the Medicaid process, I think they’ll be pleasantly surprised,” said Smith, who has …"

Feds propose shakeup for emergency room billing

By Fred Schulte

Proposal seeks to counter alleged over-billing with standardized rate

Excerpts from this story referencing "Medicaid":

"… vites overcharges. Now in a major turnabout, the Centers for Medicare and Medicaid Services are seeking tighter controls over the fees as part of a plan to r …"

Obamacare facts separated from spin by Wendell Potter, FactCheck.org

By Bill Buzenberg

Navigating the politicized issue of the Affordable Care Act is made easier by Wendell Potter and FactCheck.org.

Excerpts from this story referencing "Medicaid":

"… quirement that all Americans not covered by a public plan like Medicare or Medicaid must buy coverage from a private insurance company. The second provis …"

"… an Obamacare policy.’” “In fact, that poor guy will be eligible for Medicaid coverage or heavily subsidized private insurance, depending on where he li …"

"… sored by our employers. Another 32 percent of us are enrolled in Medicare, Medicaid and other public programs. That means, Potter said, that “almost nine ou …"

The other Washington could hold the key to Medicare's cost crisis

By Joe Eaton

Washington state won't pay for medical procedures that don't work. Why can't Medicare do that?

Excerpts from this story referencing "Medicaid":

"… nt health or are not worth the price tag. But the Centers for Medicare and Medicaid Services (CMS), the agency that administers the program, has for the most …"

"… s paid for by state public employee insurance, worker’s compensation and Medicaid, the joint federal-state insurance program for low-income individuals and …"

"… or ineffective procedures. Most importantly, the Centers for Medicare and Medicaid Services have no authority to consider cost in their coverage policy decis …"

"… cisions are actually made in Washington, D.C. The Centers for Medicare and Medicaid Services administers the program, but the nuts-and-bolts processes of runn …"

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 "Medicaid":

"… nation’s largest dental chains for children should be thrown out of the Medicaid program for encouraging dentists to perform unnecessary treatments to boos …"

"… e ownership change as one reason he didn’t exclude Small Smiles from the Medicaid program despite repeated problems found during clinic inspections. "We've …"

"… ded that the HHS inspector general exclude not only Small Smiles from Medicaid but “any other corporate entity that employs a fundamentally deceptive b …"

"… those offices. The report urges states to enforce their laws. Cutting off Medicaid reimbursements could fatally wound Small Smiles, which specializes in trea …"

Medicare fraud outrunning enforcement efforts

By Fred Schulte

Agency couldn't investigate 1,200 complaints, and more cuts coming.

Excerpts from this story referencing "Medicaid":

"… s are set to scale back or drop a host of investigations into Medicare and Medicaid fraud and abuse — even though cracking down on government waste and cutt …"

"… hearing that his unit “is shrinking” even as the federal Medicare and Medicaid programs grow in size and complexity. “We’re set to lose roughly 400 b …"

"… Medicare, which serves the elderly, is paid for by federal tax dollars. Medicaid, for low-income people, is jointly funded by the federal and state governm …"

"… low-income people, is jointly funded by the federal and state governments. Medicaid is set to expand by as many as 20 million people starting next year under …"

IMPACT: 'Dentists' probe leads to new Texas law

By David Heath

Center's 'Dollars and Dentists' investigation brings about new Texas law.

Excerpts from this story referencing "Medicaid":

"… led a pattern of questionable practices by Kool Smiles, a chain focused on Medicaid-provided dental care for children. The spokesman also credited independent …"

"… spokesman also credited independent reporting by Dallas station WFAA-TV on Medicaid fraud. The joint investigation by the Center and Frontline, titled “Dol …"

"… tatement. Kolkhorst said only one dentist had has his license revoked for Medicaid fraud or patient complaints in the past two years. “That’s just not ac …"

OPINION: an outbreak of bipartisanship

By Wendell Potter

Republicans, Democrats work together to expand Medicaid.

Excerpts from this story referencing "Medicaid":

"… during state legislative sessions this year has been whether to expand the Medicaid program for low-income individuals and families, as Congress intended when …"

"… urt ruled last year that Congress can’t force the states to expand their Medicaid programs, even if the feds will always cover no less than 90 percent of th …"

"… s, even if the feds will always cover no less than 90 percent of the cost. Medicaid is jointly funded by the states and the federal government. All of the st …"

"… ama administration that they would take the federal money and expand their Medicaid programs to include families with incomes up to 138 percent of the federal …"

OPINION: smoothing out Medicaid's 'churn'

By Wendell Potter

Proposed legislation would protect folks from briefly losing benefits.

Excerpts from this story referencing "Medicaid":

"… That’s because it only affects the poorest among us who are eligible for Medicaid. The problem is referred to by policy wonks as “churn.” Because of th …"

"… problem is referred to by policy wonks as “churn.” Because of the way Medicaid is administered by the states, millions of Americans enrolled in the progr …"

"… m the rolls simply because they can’t take time off from work to go to a Medicaid office to re-verify their incomes every three months, which some states re …"

"… rance industry jargon — are eventually reinstated. Their eligibility for Medicaid never changed. They lost coverage solely because of paperwork requirements …"

OPINION: taking advantage of Medicare Advantage

By Wendell Potter

Feds have been overpaying for Medicare Advantage.

Excerpts from this story referencing "Medicaid":

"… ut in payments to Medicare Advantage plans by the Centers for Medicare and Medicaid Services (CMS) that are scheduled to go into effect on April 1. The indus …"

OPINION: drug firms say no to rebates, despite billions in new revenue from Part D

By Wendell Potter

Part D brought drug companies billions, but they say the sky is falling

Excerpts from this story referencing "Medicaid":

"… ly 50 millions Medicare beneficiaries, about a fifth are also eligible for Medicaid because of their low incomes.  Before the Medicare Part D drug progr …"

"… went into effect and the dual eligibles’ drug coverage was switched from Medicaid to Medicare. As a result, taxpayers are paying more now than before, even …"

OPINION: what insurers aren't telling you

By Wendell Potter

Insurers cite studies that don't tell the whole story

Excerpts from this story referencing "Medicaid":

"… y can’t find a job that offers coverage, or through the expansion of the Medicaid program or the availability of premium subsidies for low-income individual …"

"… ght million of the currently uninsured 18 to 34-year-olds will qualify for Medicaid if all states expand eligibility to include people earning up to 138 perce …"

Texas tries to crack down on dental chains that put profits ahead of patients

By David Heath

GOP legislator in Texas says its time to end "outrageous activities" of corporate dental chains.

Excerpts from this story referencing "Medicaid":

"… ivities involving the illegal enticement of patients, especially among our Medicaid providers and often involving dental service organizations,” said Republ …"

"… mmittee.Nelson did not name a specific chain. Aspen Dental does not accept Medicaid and has no offices in Texas. But Kool Smiles has clinics throughout Texas, …"

"… how that the state Attorney General has been investigating Kool Smiles for Medicaid fraud.Texas has been embroiled in a Medicaid fraud scandal for the past co …"

"… investigating Kool Smiles for Medicaid fraud.Texas has been embroiled in a Medicaid fraud scandal for the past couple of years. The initial focus was on overb …"

Medicare paid $3.6 billion for electronic health records but didn't verify quality goals were met

By Fred Schulte

Medicare paid providers billions to adopt electronic records without checking to see they're meeting quality goals

Excerpts from this story referencing "Medicaid":

"… hem to improve the quality of health care.But the Centers for Medicare and Medicaid Services has since paid out more than $3.6 billion to medical professional …"

OPINION: 'Disrupt' the new buzzword of Obamacare opponents

By Wendell Potter

OPINION: 'Disrupt' is the new buzzword of Obamacare opponents

Excerpts from this story referencing "Medicaid":

"… buy coverage from private insurers if we’re not eligible for Medicare or Medicaid.The Congressional Budget Office estimates that 32 million uninsured Americ …"

"… coverage as a result of the law. While many will be newly eligible for the Medicaid program, millions of others will get subsidies from the federal government …"

Blistering inspector general report says feds are failing to fight Medicaid home care fraud

By Joe Eaton

Report says feds not doing enough to root out fraud in Medicaid personal services

Excerpts from this story referencing "Medicaid":

"… home to be homebound to.” …"

"… heila McDonald, for the job. In 2011, McDonald received almost $5,000 from Medicaid for six months of care she provided to Foreman.These personal care service …"

"… General (OIG) report scheduled to be released today faults the Centers for Medicaid and Medicare Services (CMS) for inadequate oversight of personal care serv …"

"… costs are shared by states and the federal government, as is the norm for Medicaid.  The report, which brings together six years of OIG investigations a …"

OPINION: a bit of truth-telling on Obamacare

By Wendell Potter

The rhetoric has obscured the Affordable Care Act's many benefits

Excerpts from this story referencing "Medicaid":

"… n is not going to add trillions to the deficit, even though it will expand Medicaid and provide subsidies to low-income individuals and families to buy privat …"

"… million if all the states agree to accept federal dollars to expand their Medicaid programs.That said, Obamacare is not a panacea for all that ails the U.S. …"

OPINION: Center series demonstrates dangers of 'captured' regulators

By Wendell Potter

Center series demonstrates dangers of special interest influence

Excerpts from this story referencing "Medicaid":

"… affecting them. In many regards,  the Centers for  Medicare and Medicaid Services (CMS) has become a “captured agency” as a result of decisions …"

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